膀胱癌癌旁组织p53、bcl-2表达及其临床意义

目的　探讨膀胱癌癌旁组织的组织病理学及突变蛋白p5 3、bcl 2的表达情况 ,以提高对膀胱癌恶性程度的认识及提高对膀胱癌的疗效。方法　采用免疫组化S P法 ,对 5 8例膀胱癌标本 ,取癌组织、癌旁 2cm、癌旁 3cm以及癌旁 3cm以上组织 ;分别进行 p5 3、bcl 2检测。 结果　 5 8例膀胱癌癌旁黏膜组织中 ,正常膀胱黏膜 2 5例 ,癌旁癌变 13例 ,癌前病变 2 0例。不同病理分期及分级的膀胱癌组织 p5 3阳性表达率有非常显著性差异 (P <0 .0 1) ;浅表性膀胱癌与浸润性膀胱癌bcl 2阳性表达率比较有显著性差异 (P <0 .0 5 ) ,不同病理分级膀胱癌组织中bcl 2阳性表达有非常显著性差异 (P <0 .0 1)。结论　p5 3阳性表达、bcl 2阴性表达的膀胱癌多具浸润性强、分化较差的特点。bcl 2阳性表达、p5 3阴性表达的膀胱癌浸润性弱、分化较好。癌旁组织恶变发生率浸润性膀胱癌为 5 6.4%、浅表性膀胱癌为 2 1.1% ,提示手术时应尽可能保证足够的切除范围

Clinic Significance of p53 Protein and bcl-2 Gene Expression in Bladder Peritumoral Tissue

Objective To investigate the clinic significance of pathology and the expression of the mutate p53 protein,bcl-2 gene in peritumoral tissue of bladder carcinoma.Methods The expression of p53 protein and bcl-2 gene was analyzed by SP method in specimens from 58 cases with bladder carcinoma.The specimens were taken from the tumor and the peritumoral tissue(2 cm,3 cm and >3 cm).Results In the peritumoral tissue from the 58 cases,there were 25 cases of normal mucosa,13 cases of tumoral lesions and 20 cases of pretumoral lesions.The expression of p53 protein was significantly different in tumor with different pathological grade and stage(P<0.01).The expression of bcl-2 was significantly different in tumor with different pathological grade(P<0.01),or between the superficial and the invasive bladder cancer(P<0.05).Conclusion The positive expression of p53 protein and negative expression of bcl-2 in bladder incicates high invasion and low differentiation with a poor prognosis.The occurence of the development of cancer in the peritumoral tissue was 56.4% in the invasive bladder cancer and 21.1% in superficial bladder cancer.Therefore,extension resection of the tumoral lesion should be performed during the operation.