bcl-2、p53蛋白表达在卵巢子宫内膜异位症癌变过程中的作用

目的 探讨p53、bcl-2蛋白表达在卵巢子宫内膜异位症（内异症）癌变过程中的作用。方法 采用免疫组化法检测卵巢子宫内膜异位症组（内异症组，22例）、卵巢异位子宫内膜腺上皮不典型增生组（不典型增生组，14例）、卵巢子宫内膜异位症癌变组（癌变组，22例）的p53、bcl-2蛋白表达。结果 癌变组bcl-2蛋白表达阳性率显著高于内异组（P＜0．05），不典型增生组bcl-2 蛋白表达阳性率显著高于内异组（P＜0．01）；癌变组p53蛋白表达阳性率显著高于不典型增生组（P＜0．01）及内异组（P＜0．01），癌变组癌变区p53蛋白表达阳性率显著高于内异区（P＜0．05）；癌变组内异区bcl-2蛋白表达阳性率显著高于内异组（P＜0．05），不典型增生组内异区bcl-2蛋白表达阳性率显著高于内异组（P＜0．01）。bcl-2、p53蛋白表达与绝经与否、肿瘤期别、生存期无明显相关性（P＞0．05）；癌变组癌变区p53、bcl-2蛋白表达无明显相关性（P＞0．05）。结论 p53、bcl-2的过度表达可能参与了内异症癌变的过程，p53蛋白阳性或bcl-2蛋白阳性的内异症可能是癌前病变。

bcl-2 and p53 protein expressions in the malignant transformation of ovarian endometriosis

OBJECTIVE: To study the impact of bcl-2 and p53 protein expressions on the malignant transformation of ovarian endometriosis. METHODS: Immunohistochemical technique was used to detect the bcl-2 and p53 protein expressions in: endometriosis (Group I, 22 patients), atypical hyperplasia of ectopic ovarian endometrial glands (Group II, 14 patients) and endometriosis with malignant change (Group III, 22 patients). RESULTS: The positive bcl-2 protein expression rate of Group III was apparently higher than that of Group I (P < 0.05); The positive bcl-2 protein expression rate of Group II was clearly higher than that of Group I(P < 0.01). The positive p53 protein expression rate of Group III was higher than that of Group II (P < 0.01) and Group I (P < 0.01); In Group III, the positive p53 protein expression rate was higher in the malignant transformation area than in the endometriosis area (P < 0.05); In Group III, the positive bcl-2 protein expression rate in the endometriosis area was higher than that of Group I (P < 0.05); In Group II, the positive bcl-2 protein expression rate in the endometriosis area was higher than that of Group I (P < 0.01); However, the bcl-2 and p53 protein expressions were not related to the menopause, stage of disease or the survival (P > 0.05), nor were they related to the malignant transformation area in Group III (P > 0.05). CONCLUSION: It is possible that the overexpressions of bcl-2 protein or p53 protein play an important role in the malignant transformation of ovarian endometriosis. The bcl-2 protein (+) or p53 protein (+) endometriosis may signify a precancerous lesion.