p27和增殖细胞核抗原及增殖相关核抗原在滑膜肉瘤中的表达及临床意义

目的 观察p27、增殖细胞核抗原(PCNA)、增殖相关核抗原(ki-67)在滑膜肉瘤中的表达,探讨三者的相互关系及对预后的影响.方法 10例正常滑膜和36例滑膜肉瘤石蜡切片标本,采用免疫组化(SP)方法,观察、p27,PCNA、ki-67在正常滑膜和滑膜肉瘤中的表达;通过对比分析,比较p27、PCNA、ki-67在滑膜肉瘤表达中的相关性;根据滑膜肉瘤镜下组织学分级、组织学分型和临床分期,分析p27、PCNA、ki-67表达与预后的关系.结果 ①正常滑膜组织中p27呈高表达100%(10/10)],PCNA和ki-67无表达(0、0);滑膜肉瘤中p2711.1%(4/36)]呈低表达,PCNA86.1%(31/36)]和ki-6769.4%(25/36)]呈高表达;p27、PCNA、ki-67在正常滑膜和滑膜肉瘤之间的表达比较差异有统计学意义(χ2值分别为25.16、22.63、12.54,P＜0.05).②p27表达与滑膜肉瘤的组织学分级、预后有关(χ2值分别为9.19、5.98,P＜0.05),与组织学类型、临床分期无关(χ2值分别为0.77、0.29,P＞0.05);PCNA和ki-67的表达与滑膜肉瘤的临床分期、组织学分级、预后有关(χ2值分别为7.40、8.12,7.17、9.18,13.03、10.66,P＜0.05),与组织学类型无关(χ2值分别为0.64、0.36,P＞0.05).③p27与PCNA表达呈负相关(r=-0.63,P＜0.05),p27与ki-67表达呈负相关(r=-0.53,P＜0.05),PCNA与ki-67的表达呈正相关(r=0.63,P＞0.05).结论 p27在滑膜肉瘤组织中表达缺失,PCNA和ki-67在滑膜肉瘤中呈高表达,滑膜肉瘤细胞增殖过程中p27与PCNA、ki-67互相调节共同发挥作用,联合检测p27和PCNA、ki-67表达对判断滑膜肉瘤患者的预后更有价值.

The expressions and clinical sig nificances of p27 and proliferating cell nuclear antigen and nuclear-associated antigen in synovial sarcoma

Objective To investigate the association of the expressions of p27 and proliferating cell nuclear antigen(PCNA)and nuclear-associated antigen(ki-67)proteins in synovial sarcoma,and the relationship with its prognosis.Methods The expression of p27,PCNA and ki-67 in 36 synovial sarcoma and 10 normal synovial tissue were immunohistochemically examined.The relationship between the expressions of p27,PCNA and ki-67 proteins in synovial sarcoma with its prognosis by clinical stage,tissue grades and prognosis was investigated.Results (1)In normal synovial tissue,the expressions of PCNA(0) and ki-67(0) were positive,p27 were positive100%(10/10).but the expressions of PCNA86.1%(31/36)]and ki-6769.4%(25/36)]in most synovial sarcoma were positive,p27 were negative11.1%(4/36)],significant differences were found among these expressions(χ2=25.16,χ2=9.18,P＜0.05).(2) p27 positive-expression correlated significantly wiht the histological grade of synovial sarcoma(χ2=9.19,P＜0.05)and prognosis(χ2=5.98,P＜0.05).The positive expressions of PCNA and ki-67 were positively related with the clinical stage(χ2=7.40,χ2=8.12,P＜0.05)and tissue grades(χ2=7.17,χ2=9.18,P＜0.05)and prognosis(χ2=13.03,χ2=10.66,P＜0.05)of synovial sarcina(3) There were negative correlations between p27 and PCNA(r=-0.63,P＜0.05) and between p27 and ki-67(r=-0.53,P＜0.05).But positive correlation between PCNA and ki-67(r=0.63,P＞0.05)was found.Conclusions Expressions of PCNA and ki-67 in most synovial sarcomas are positive,and that of p27 is negative,each plays an important role in the proliferation of synovial sarcoma.Combination of measuring of the p27,PCNA and ki-67 is valuble in predicting the prognosis.