p53、Ki-67基因表达与膀胱癌生物学特性的研究

目的 探讨p53、Ki-67基因表达与膀胱移行细胞癌(BTCC)病理分级、临床分期及复发的关系.方法 收集149例BTCC患者的临床资料及p53、Ki-67表达阳性率.结果 Ⅰ～Ⅱ级BTCC p53、Ki-67阳性率分别为58.8%、64.7%,低于Ⅲ级BTCC p53、Ki-67的阳性率(80.014%、90.0%)(P<0.05,P<0.01);浸润型BTCC的p53、Ki-67基因表达阳性率(80.0%、92.3%)均高于浅表型BTCC阳性率(50.0%、52.4%)(P<0.01).在高分级、高分期BTCC组p53、Ki-67联合表达率(73.3%、73.8%)高于低分级、低分期BTCC组(45.4%、32.1%)(P<0.05).p53、Ki-63共同表达阳性者复发率为37.2%,单一阳性或阴性表达者复发率16.1%,两组复发率有显著性差异(P<0.05).结论 p53、Ki-67基因表达与BTCC的临床分期、病理分级相关,提示p53、Ki-67蛋白过度表达的BTCC高度恶性和预后不良;p53、ki-67基因共同表达阳性组复发率较单一阳性或阴性组复发率高,提示p53和ki-67基因联合表达与BTCC复发可能有相关性.     

Clinical relevance of p53 index and expression of proliferating cell nuclear antigen and Ki-67 in gastric cancer

The prognostic value of the immunohistochemical expression of p53 protein, proliferating-cell nuclear antigen (PCNA) and Ki-67 antigen was evaluated in a series of 116 stage I–II gastric cancer patients. The staining for p53 protein (staining frequency and intensity) in malignant cells was expressed as a p53 index. Similarly, the staining frequency and intensity for PCNA and Ki-67 were evaluated. The p53 index was independent of the stage and differentiation grade, but significantly related to DNA ploidy, S-phase fraction and mitotic activity. A high p53 index was a sign of inferior survival, compared to a low or intermediate index. p53-negative tumours were also associated with poor survival. In a multivariate analysis, only the depth of tumour infiltration and the presence of nodal metastases were independent prognostic factors in stage I–II gastric cancer. PCNA expression and Ki-67 antigen expression were not related to the stage, ploidy, proliferative activity or p53 expression, and they had no impact on survival. The results indicate that p53 protein expression may be of prognostic significance in gastric cancer, while PCNA and Ki-67 antigen expression have no predictive value. Received: 2 February 1998 / Accepted: 16 June 1998     

Gallbladder carcinoma: the role of p53 protein overexpression and Ki-67 antigen expression as prognostic markers

BackgroundThe overexpression of p53 protein and the expression of Ki-67 antigen may affect the survival of patients with gallbladder carcinoma. This association has been tested in a series of 41 patients with relatively early carcinoma of the gallbladder.MethodsForty-one surgical specimens from patients with a postoperative histological diagnosis of gallbladder carcinoma were studied. All patients were operated by simple cholecystectomy only because the tumours were not advanced and/or their general condition was poor. Patients submitted to radical operations were excluded. p53 expression was calculated from nuclear staining according to the intensity and extent of positive cells, as graded on a scale from 1 to 3; a combined score of >3 was considered as overexpression. Ki-67 expression was calculated by the MIB-I index: the percentage of positively stained tumour cell nuclei out of the total tumour cells counted (n = 1000); >20% of stained cells was considered positive.ResultsTwenty-nine gallbladder carcinomas (71%) overexpressed p53 protein in the cell nuclei. No significant differences were found in relation to cell differentiation on the level of tumour infiltration through the gallbladder wall. Five-year survival of patients with gallbladder carcinoma overexpressing p53 was 17.2%, while survival of patients without p53 overexpression was 30% (not significant). Twenty-four cases (58.5%) were considered positive for the MIB-I index. There were no differences between the grade of cell differentiation and wall infiltration. Five-year survival of the patients with a MIB-I positive index was 9.2% as opposed to 27.7% for those with a negative index (not significant).Conclusionsp53 protein nuclear overexpression and Ki-67 protein expression in gallbladder carcinoma were not related to histological differentiation, level of gallbladder wall invasion or patient survival.     

肺癌组织中P53和Ki-67的表达及意义

目的 观察P53和Ki-67在肺癌组织中的表达状况及其与病理和临床特征的意义.方法 采用免疫组织化学SP法检测233例肺癌组织中P53和Ki-67的表达,结合临床资料进行分析.结果 肺癌组织中P53和Ki-67的阳性表达率分别为80.7％和99.6％,其中低阳性表达率分别占了阳性表达率的44.2％和57.2％.P53的表达与肺癌组织类型无明显关系,而Ki-67的表达与肺癌组织类型有一定关系,鳞癌以高表达为主,而腺癌与细支气管肺泡癌以低表达为主;P53在淋巴结转移组的阳性表达率为95.0％,高于无淋巴结转移组,而Ki-67的表达与淋巴结是否转移无明显关联.结论 肺癌组织中P53和Ki-67阳性表达率高,但低阳性表达的病例占了相当的比例,两者可能共同参与了肺癌的发生、发展,P53与肺癌淋巴结转移的关系可能更大,而Ki-67的阳性表达程度与病理类型有关.     

Differential expression of Bcl-2, Bcl-XL and p53 in colorectal cancer

AIMS: The balance between proliferation and apoptosis is often disturbed in cancer. The aim of this study was to investigate the possible role of Bcl-2 gene family members and p53 as prognostic factors in a series of colorectal cancer. METHODS: The immunohistochemical expression of Bcl-2 gene family members (Bcl-2 and Bcl-X(L)) and p53 was evaluated in 81 surgical specimens of primary human colorectal cancers to establish the role of these genes in colorectal cancer and to evaluate their prognostic importance. RESULTS: The expression of Bcl-2 correlated with early clinical stage and lack of lymphovascular invasion and lymph node involvement. The expression of p53 correlated with less differentiated status and with perineural invasion. p53 expression showed negative correlation with Bcl-X(L) expression (P = 0.025) and no correlation with Bcl-2 expression. CONCLUSIONS: p53 expression may be a less favorable marker and Bcl-2 expression a more favorable marker of behavior. Bcl-2 and Bcl-X(L) may play an independent role in disease progression, and the expression of these proteins may be under independent regulatory control in colorectal cancer.     

Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy

AIM: To investigate whether tumor marker staining can improve the sensitivity of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) to diagnose pancreatic malignancy.METHODS: Patients who underwent EUS-FNA were retrospectively identified. Each EUS-FNA specimen was evaluated by routine cytology and stained for tumor markers p53, Ki-67, carcinoembryonic antigen (CEA) and CA19-9. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (PLR and NLR) were calculated in order to evaluate the performance of each test to detect malignancy.RESULTS: Sixty-one specimens had complete sets of stains, yielding 49 and 12 specimens from pancreatic adenocarcinomas and benign pancreatic lesions due to pancreatitis, respectively. Cytology alone had sensitivity and specificity of 41% and 100% to detect malignancy, respectively. In 46% of the specimens, routine cytology alone was deemed indeterminate. The addition of either p53 or Ki-67 increased the sensitivity to 51% and 53%, respectively, with perfect specificity, PPV and PLR (100%, 100% and infinite). Both stains in combination increased the sensitivity to 57%. While additional staining with CEA and CA19-9 further increased the sensitivity to 86%, the specificity, PPV and PLR were significantly reduced (at minimum 42%, 84% and 1, respectively). Markers in all combinations performed poorly as a negative test (NPV 26% to 47%, and NLR 0.27 and 0.70).CONCLUSION: Immunohistochemical staining for p53 and Ki-67 can improve the sensitivity of EUS-FNA to diagnose pancreatic adenocarcinoma.     

Expression of COX-2, PCNA, Ki-67 and p53 in gastrointestinal stromal tumors and its relationship with histopathological parameters

AIM： To investigate the expression of Cyclooxygenase-2 （COX-2）, proliferating cell nuclear antigen （PCNA）, Ki-67 and p53 in gastrointestinal stromal tumors （GISTs） and its relationship with histopathological parameters.
METHODS： Twenty-five GISTs were examined by light microscopy and immunohistochemistry, c-kit, CD34, SMA, S-100 protein, COX-2, PCNA, Ki-67 and p53 were detected immunohistochemically and the relationship was evaluated among histopathologic parameters such as mitotic index （MI）, tumor grade, tumor size, COX-2, PCNA, Ki-67 and p53.
RESULTS： COX-2 protein expression was found in 19 of 25 （76%） of the tumors, and expression was noted in the cytoplasm of the tumor cells, p53 was significantly related to MI and tumor grade but no relationship was found between COX-2, proliferation markers and MI, tumor grade and tumor size.
CONCLUSION： COX-2 is expressed in most GISTs and it may play an important role in the proliferation and progression of these tumors or a useful marker to identify GIST. Although immunohistochemical assessment of p53 can be used for distinguishing the risk groups of GISTs, tumor size and mitotic rate should be considered at the same time.     

Survivin, p53, and Ki-67 as predictors of histopathologic response in locally advanced rectal cancer treated with preoperative chemoradiotherapy

Purpose The ability to predict response to chemoradiotherapy before the treatment may allow protecting poorly responding patients from the side effects of neoadjuvant treatment. Several molecular markers have been proposed to radio and chemosensitivity of rectal cancer. In this study, from pre-irradiation tumor biopsies, a novel and promising candidate factor survivin, and p53 and Ki-67 were assessed as predictors of response to preoperative chemoradiotherapy. Materials and methods Expression of each marker was evaluated by immunohistochemistry on pretreatment biopsies from 37 patients having rectal cancer treated with preoperative chemoradiotherapy and curative surgery. Treatment response was assessed histopathologically in the resected surgical specimen. Results There was no correlation between expression of p53, Ki-67, and survivin with response to preoperative chemoradiotherapy and prognosis. Conclusions Our data suggest that these molecular markers are not helpful to identify patients who would have benefit from neoadjuvant treatment of rectal cancer. Further investigations are necessary to select patients for preoperative treatment based on analysis of the preoperative biopsies.     

Prognostic role of p53 and Ki-67 immunohistochemical expression in patients with surgically resected lung adenocarcinoma: a retrospective study

Objective

p53 mutations and the Ki-67 protein are frequently observed in various types of human cancer; the abnormal expression of p53 and Ki-67 in the tumor is associated with poor survival of lung cancer patients. We aimed to assess the prognostic role of immunohistochemical (IHC) expression of p53 and Ki-67 in lung adenocarcinoma tissue.

Methods

Tumor samples from 136 patients who had undergone surgical resection for lung adenocarcinoma were retrospectively evaluated for p53 and Ki-67 expression by immunohistochemistry. Associations of clinical and pathologic variables with p53 and Ki-67 were determined using the χ² test. After excluding two patients (follow-up loss), 134 cases were evaluated for associations between p53, Ki-67, clinical and pathologic variables, and survival by using the Cox proportional hazards regression model and Kaplan-Meier method.

Results

In the 136 patients, p53 was positive in 71.0% (93/131), and Ki-67 showed high in 49.2% (61/124). Unlike p53, Ki-67 was associated with male sex, smoking, and poor tumor differentiation (P=0.004, P=0.001 and P=0.006). Of these, poor tumor differentiation strongly was correlated with high level of Ki-67 expression (P=0.008). Neither p53 nor Ki-67 was associated with increased risk of death (P=0.318, P=0.053); however, age ≥60 years and lymph node involvement were significant predictors of death (P=0.039 and P=0.042). The log-rank test revealed a significant association between Ki-67 and lower survival in all patients (χ²=5637; P=0.018); however, the risk was limited to stage III cases (χ²=5.939; P=0.015). Unlike p53, patients with high level of Ki-67 expression showed lower 3-year actuarial survival than those without (log-rank test, χ²=4.936; P=0.026).

Conclusions

IHC expression of Ki-67 in lung adenocarcinoma tissue shows stronger association with poor tumor differentiation, and negatively affects patients’ survival in advanced-stage lung cancer; however, the role of p53 on patient outcome needs further study.     

C-erbB-2、p53的联合检测对大肠癌预后的多因素分析

目的研究大肠癌患者肿瘤组织C-erbB-2、p53的表达与临床病理学类型及预后的联系。方法应用免疫组织化学sP法检测有完整随访资料的126例大肠癌术后肿瘤组织的p53,C-erbB-2蛋白的表达,应用Kap-lan—Meier法Cox比例风险模型分析检测结果同预后关系。结果在126例大肠癌患者中,组织中p53阳性表达65例（51．6％）,C—erbB-2阳性表达60例（47．6％）,p53与C—erbB-2阳性表达均与区域淋巴结转移显著相关。p53与C—erbB-2阴性患者的生存率要高于阳性患者。多因素COX回归分析显示,p53、Dukes分期、年龄能反映大肠癌的预后情况,C-erbB-2、p53和Dukes分期是大肠癌的独立预后指标。结论检测C—erbB-2和p53可能有助于筛选出具有高复发及转移倾向的大肠癌患者。     

Correlation of Ki-67, p53, and Adnab-9 immunohistochemical staining and ploidy with clinical and histopathologic features of severely dysplastic colorectal adenomas

Variations of Ki-67, p53, and Adnab-9 monoclonal antibody reactions in colonic adenomas may be associated with colonic cancer risk. We studied the predictive value of these markers for adverse behavior in severely dysplastic colorectal adenomas, such as an associated carcinoma, multiplicity of adenomas, and subsequent development of adenomas. For this purpose we compared the clinical, gross, and histologic characteristics of highly dysplastic index polyps in 42 patients with Ki 67, p53, and Adnab-9 immunostaining and other molecular markers. Polyps were removed endoscopically, and severely dysplastic polyps were stained immunohistochemically with Ki-67, Adnab-9, and p53 protein by the avidin biotin conjugate (ABC) technique. Quantitative DNA (QDNA) was analyzed by computer-assisted image analysis. Ki-67 immunohistochemistry showed reversal of normal distribution of nuclear staining from the normal basal position to the upper third of the colonic crypts. This abnormality of immunostaining in dysplastic adenomas was the earliest detected by the panel we used. A statistically significant correlation was seen between invasiveness of carcinoma in the index polyp and polyp size (P = 0.003), sessile morphology (P = 0.037), and villous or tubulovillous histology (P = 0.019). In the index adenoma, p53 positivity was correlated with multiplicity at initial examination (P = 0.053), villous histology (P = 0.053), invasiveness of carcinoma (P < 0.003), and recurrence of colorectal adenomas (P = 0.025). Although p53 positivity and aneuploidy were correlated with invasiveness of carcinoma in the index polyp (P = 0.025), Adnab-9 positivity was not. However, Adnab-9 positivity in the index polyp was associated with multiplicity of adenomas (P = 0.04) as well as recurrence of adenomas (P < 0.024). In conclusion, in addition to the morphologic and histologic markers already known, Ki-67, Adnab-9 antibody, and p53 protein may be prognostic indicators useful in follow-up of patients with severely dysplastic colorectal adenomas. Adnab-9 antibody may identify a field defect in above-average-risk adenoma-bearing patients.     

Expression of Ki-67, p53, and K-ras in chronic pancreatitis and pancreatic ductal adenocarcinoma

AIM: To examine surgical specimens of pancreas with either chronic pancreatitis or pancreatic cancer in order to study whether ductal hyperplasia and dysplasia in pancreas represent precursor lesions for pancreatic cancer. METHODS: We examined expression of Ki-67, CEA, p53, and K-ras, in the surgical specimens of pancreas with adenocarcinomas (n= 11) and chronic pancreatitis (n = 12). Cellular proliferation was assessed by Ki-67 proliferation index using the proliferation marker Ki-67. In specimens with pancreas cancer, we divided pancreas epithelium into normal (n = 7), ductal hyperplasia (n = 3), dysplasia (n = 4), and cancerous lesion (n = 11) after hematoxylin and eosin staining, Ki-67, and CEA immunohistochemical staining. In cases with chronic pancreatitis, the specimen was pathologically examined as in cases with pancreas cancer, and they were also determined as normal (n = 10), ductal hyperplasia (n = 4), or dysplasia (n = 5). p53 and K-ras expression were also studied by immunohistochemical staining. RESULTS: In pancreatic cancer, the Ki-67 index was 3.73±3.58 in normal site, 6.62±4.39 in ductal hyperplasia, 13.47±4.02 in dysplasia and 37.03±10.05 in cancer tissue, respectively. Overall, p53 was positive in normal ducts, ductal hyperplasia, dysplasia, and carcinoma cells in 0 of 14 (0%), 0 of 7(0%), 7 of 9 (78%), and 10 of 11 (91%), respectively, and K-ras was positive in 0 of 8 (0%), 1 of 3 (33%), 4 of 6 (67%), 4 of 5 (80%), respectively. CONCLUSION: Our results favorably support the hypothesis that ductal hyperplasia and dysplasia of the pancreas might be precursor lesions for pancreas cancer. Further evaluation of oncogenes by the molecular study is needed.     

Relationship between somatostatin receptor subtype expression and clinicopathology, Ki-67, Bcl-2 and p53 in colorectal cancer

AIM: To study the SSTR1, 2, 3, 4, 5 expression and their relationships with clinico-pathological factors, cell proliferation, Bcl-2 and p53 expression in colorectal cancer cells. METHODS: Immunohistochemical staining of five SSTR subtypes, Ki-67, Bcl-2 and p53 was performed by the standard streptavidin-peroxidase (SP) technique for the paraffin sections of 127 colorectal cancers, and expression of five SSTR subtypes in 40 specimens of normal colorectal mucosae was detected with the same method. RESULTS: Positive staining for five SSTR subtypes was observed in colorectal cancer cells and normal colorectal mucosae. SSTR1 was the most predominant subtype in both colorectal cancer and normal colorectal mucosa, and the second was SSTR5 or SSTR2. As compared with normal colorectal mucosa, SSTR4 was more frequently expressed in colorectal cancer cells (2.5% vs 18.9%, P< 0.05); the expression of SSTR2, 4, 5 in moderately to well differentiated colorectal adenocarcinoma was significantly higher than that in poorly differentiated ones (P< 0.05), the SSTR1 expression in colorectal cancer with positive lymph node metastasis was significantly higher than that with negative lymph node metastasis (72.2% and 54.5%, P< 0.05). In addition, in the ulcerative type of colorectal cancer, SSTR2 expression was obviously decreased (P < 0.05); the correlation did not reach a statistical significance between the five SSTR subtypes expression and Dukes'stages (P> 0.05), but the frequency of SSTR1 expression increased with Dukes' stage, while SSTR3 and SSTR5 expression decreased with Dukes' stage. Moreover, there was no correlation between expression of the five SSTR subtypes and other clinicopathological factors such as age, sex, tumor site, tumor depth, distant metastasis. The proliferative indexes in colorectal cancer cells with negative expression of SSTR2 and SSTR3 were significantly higher than that with positive expression (P<0.05). The Bcl-2 expression in colorectal cancer cells with positive expression of SSTRl, 2, 3, 5 was significantly lower than that with negative expression (P<0.05). There was no correlation between five SSTR subtypes and p53 expression. CONCLUSION: The most predominant SSTR subtype is SSTR1, and the second is SSTR2 or SSTR5. Five SSTR subtypes play different roles in the development of colorectal cancer. SSTR2 and SSTR3 can inhibit the proliferation and promote apoptosis of tumor cells.     

Evaluation of malignancy using Ki-67, p53, EGFR and COX-2 expressions in gastrointestinal stromal tumors

AIM: To investigate the role of expressions of Ki-67, p53, epidermal growth factor receptor (EGFR) and cyclooxygenase-2 (COX-2) in gastrointestinal stromal tumor (GIST) grading and prognosis.METHODS: Tumor tissue was collected retrospectively from 96 patients with GIST. Antibodies against Ki-67, p53, EGFR and COX-2 were used for immunohistochemical staining. Tumor grading was designated according to a consensus system and the staining was quantified in 3 categories for each antibody in the statistical analysis.RESULTS: The Ki-67 expression in GISTs was significantly associated with the size of the tumors, mitotic rate and the risk of malignancy (χ² = 15.51, P = 0.02; χ² = 22.27, P < 0.001; χ² = 20.05; P < 0.001). The p53 expression was also significantly correlated with mitotic rate and the risk of malignancy (χ² = 9.92, P = 0.04; χ² = 9.97; P = 0.04). Over-expression of Ki-67 was strongly correlated with poor survival (χ² = 10.44, P = 0.006), but no correlation was found between the expression of p53, EGFR or COX-2 and survival. Multivariate analysis further demonstrated that Ki-67 expression (relative risk = 15.78, 95% CI: 4.25-59.37) could be used as an independent prognostic value for GIST patients. Adjuvant imatinib therapy could improve clinical outcomes in the patients with high risk and intermediate risk of recurrence after complete tumor resections (median survival time: 52 mo vs 37 mo, χ² = 7.618, P = 0.006).CONCLUSION: Our results indicated that the expression of Ki-67 could be used as an independent prognostic factor for GIST patients.     

survivin基因在大肠癌组织中的表达及其与bcl-2和p53基因的相关性探讨

目的 探讨survivin在大肠癌组织中的表达及其与bcl-2、p53基因表达的相关性。方法 应用免疫组织化学方法检测大肠腺癌组织中survivin及bcl-2、p53的表达,并与其在正常大肠黏膜、增生性息肉及腺瘤组织中的表达进行比较。结果survivin在正常大肠黏膜无表达,大肠腺瘤（62.5%）、大肠癌（70.9%）中survivin表达率显著高于正常大肠黏膜和增生性息肉（16.7%）（P〈0.01）;survivin表达与与肿瘤浸润深度和淋巴结转移明显相关（P均〈0.05）;大肠癌组织中bcl-2、p53基因与survivin基因表达显著相关（P均〈0.05）。结论 survivin参与了大肠癌的发生和发展,可作为判断预后的参考指标;抑癌基因p53的失活和bcl-2的表达上调与survivin基因的表达可能在大肠癌的发生、发展中起协调作用。     

Hepatic expression of the proliferative marker Ki-67 and p53 protein in HBV or HCV cirrhosis in relation to dysplastic liver cell changes and hepatocellular carcinoma

To evaluate hepatic expression of the nuclear proliferative marker Ki-67 and the p53 oncoprotein in hepatitis B virus (HBV)/HCV cirrhosis in relation to dysplastic liver cell changes and hepatocellular carcinoma (HCC). We studied needle liver biopsies from 107 patients with cirrhosis and no HCC (52 HBV, 55 HCV) who had been assessed for protocol studies, and 57 cirrhotic patients with HCC (40 HBV, 17 HCV). We evaluated small and large cell dysplastic changes along with the expression of Ki-67 and p53 by immunohistochemistry. The labelling index (LI) was defined as the proportion (%) of positive-stained nuclei of the 500 measured. Large and small cell dysplastic changes were observed in 12 and 9% of specimens respectively. Only small cell changes were associated with Ki-67 expression. Ki-67 LI was 5.50 +/- 5.7 in cirrhosis (13.90 +/- 3.84 in those with small cell dysplastic changes vs 4.64 +/- 4.98 in those without, P < 0.01), 10.2 +/- 5.95 in cirrhosis with HCC (P < 0.05) and 18.56 +/- 10 in HCC (P < 0.01). Neither the presence of small cell dysplastic changes nor the expression of Ki-67 was related to severity or aetiology of cirrhosis. Expression of p53 was observed in 30% of the non-tumorous and in 53% of the neoplastic tissue obtained from patients with HCC, with no differences between HCV and HBV. Ki-67 and p53 expression was associated with the tumour grade (P < 0.001). Our observations clearly demonstrate the association between the proliferation activity and the morphological changes in the cirrhotic liver from the non-dysplastic to dysplastic lesion to HCC. They also support the hypothesis that p53 alterations are a rather late event in carcinogenesis and related to HCC grade. And finally, they suggest that the final steps of hepatocarcinogenesis are common and independent of the aetiology of the chronic viral infection.     

Prognostic significance of Bcl-2 and p53 expression in gastric cancer

Background and aims Apoptosis regulates cell death and influences cell proliferation and therefore may play an important role in development or growth of various malignant tumors. The Bcl-2 and p53 are closely linked in the regulation of apoptosis. We investigated the prognostic significance of Bcl-2 and p53 expression in patients with gastric cancer.Patients and methods Immunohistochemistry was used to study Bcl-2 and p53 expression in 308 consecutive patients with gastric cancer.Results Bcl-2 expression was positive in 39 patients (12.7%) and showed a significant negative correlation with depth of invasion and lymph node metastasis. p53 expression was observed in 105 patients (34.1%) and was significantly associated with depth of invasion, lymph node metastasis, distant metastasis, and intestinal type. Patients with Bcl-2⁺ tumors showed a trend to better 5-year survival rate (81%) than those with Bcl-2^– negative tumors (71%). The 5-year survival rate in p53 positive cases (60%) was significantly lower than that in p53-negative cases (78%). In addition, p53 expression showed a significantly poorer prognosis in both diffuse and intestinal types. In multivariate analysis restricted to patients with R0 resection p53 expression was an independent prognostic factor (relative risk: 2.063). In combined assessment of p53 and Bcl-2 expression the group with p53⁺/Bcl-2^– tumors showed significantly worse 5-year survival (57%) than the other groups, while best survival was seen in the group with p53⁺/Bcl-2⁺ tumors (100%).Conclusion p53 expression is an unfavorable prognostic factor in gastric cancer. Bcl-2 expression may have possible prognostic value when combined with p53 expression.     

Apoptosis of colon cancer: Comparison with Ki-67 proliferative activity and expression of p53

The role of apoptosis in colon cancer was investigated in terms of control of growth and expression of p53, using the nick-ended-DNA labelling method and immunohistochemistry. The apoptotic labeling index was highest in the T1 stage (24 cases), as was the proliferative activity, assessed in terms of the Ki-67 labeling index. Both labeling indices demonstrated similar overall incidence curves for the total 95 colon cancer cases, and examination of individual cases revealed a statistically significant correlation (P=0.01). However, neither index had any relation to p53. The results thus suggest that apoptosis in colon cancers has a linkage with proliferative activity that can be assessed by Ki-67 labeling, but is not regulated by the p53 system. This might contribute to the diversity of colon cancer growth.     

胃癌CT征象与癌组织中COX-2与p53的测定

[目的]探讨胃癌CT征象与胃癌组织中COX-2与p53表达之间的关系.[方法]48例胃癌患者术前行上腹部多层CT常规与增强扫描,记录CT观察指征,观察每个病灶的浆膜侵犯与淋巴结转移等情况.应用免疫组织化学SP法检测术后胃癌组织与正常胃黏膜中COX-2与p53的表达情况,并分析胃癌多层CT征象与COX-2、p53在胃癌组织中表达之间的关系.[结果]胃癌组织中COX-2与p53的阳性表达率高于正常胃黏膜组织（P＜o.01）,胃癌CT征象上肿瘤的浆膜侵犯与COX-2、p53表达有关（P＜0.05）,淋巴结转移与COX-2、p53表达有关（P＜0.01）,胃癌组织中COX-2与p53表达有相关性（P＜0.05）.[结论]胃癌组织中COX-2与p53的高表达与胃癌CT征象上的浆膜浸润与淋巴结转移有关,CT征象可以在一定程度上反映COX-2与p53的表达,胃癌组织中COX-2与p53表达具有一致性,两者在胃癌的发展中具有协同作用.     

端粒酶催化亚单位和p53基因在大肠癌中表达的研究

目的　研究端粒酶催化亚单位 (hTERT)和p5 3基因在大肠癌组织中的表达 ,进而探讨大肠癌发生过程中端粒酶活化的分子机制。方法　分别采用原位逆转录聚合酶链反应 (RT PCR)和端粒重复序列扩增 (TRAP)法检测 46例大肠癌及其相应正常组织中hTERTmRNA表达与端粒酶活性。用免疫组化S P法测定上述组织标本中的p5 3蛋白表达。结果　hTERTmRNA与端粒酶活性在大肠癌组织中阳性表达率分别为 87 0 % (4 0 /4 6)和 80 4% (3 7/4 6) ,均明显高于相应正常组织 (P <0 .0 1)。大肠癌中hTERYmRNA表达与端粒酶活性明显相关 (r=0 .696,P <0 .0 1)。p5 3蛋白在大肠癌中阳性表达率为 67 4% (3 1/4 6) ,而正常组织未见阳性表达 ,二者比较差异有显著性 (P <0 .0 1)。大肠癌组织p5 3蛋白表达与hTERTmRNA表达或端粒酶活性无显著相关性 (P >0 .0 5 )。结论　端粒酶激活与大肠癌的发生密切相关 ,hTERTmRNA表达上调可能在大肠癌端粒酶活性调节中发挥重要作用。p5 3蛋白表达增强可能与端粒酶激活无直接相关