p53、bcl-2和nm23基因在胃癌组织中的表达及其临床意义

目的　研究胃癌组织中bcl 2、p5 3和nm2 3基因的表达及其与临床病理的关系 ,探讨bcl 2、p5 3和nm2 3基因与胃癌生物学行为的相关性。方法　采用免疫组化方法对 80例胃癌组织、3 7例不典型增生癌旁组织及 2 0例正常胃粘膜组织中的bcl 2、p5 3和nm 2 3基因的表达情况进行检测。 结果　bcl 2蛋白在胃癌癌旁轻、中、重度不典型增生组织中的表达阳性率分别为 7.1%、18.1%和 2 5 .0 % ,其在各组间表达的差异无统计学意义 (P>0 .0 5 ) ,bcl 2蛋白在高分化胃癌组织中的表达阳性率为 78.2 % ,明显高于在低分化胃癌组织中的表达 (4 8.5 % ,P<0 .0 5 )。p5 3在高分化胃癌组织中的表达阳性率为 72 .5 % ,明显低于低分化胃癌组织的 86.2 % (P<0 .0 5 )。nm 2 3在高分化胃癌组织中的表达阳性率为84.3 % ,明显高于低分化胃癌组织的 17.2 % (P<0 .0 5 )。伴有淋巴结转移的胃癌组织中nm 2 3的表达阳性率为 5 4.5 % ,低于无淋巴结转移者的表达阳性率 (85 .7% ,P<0 .0 5 )。p5 3与bcl 2在胃癌组织中的表达呈明显负相关。结论　bcl 2、p5 3和nm 2 3的表达与胃癌细胞的分化程度密切相关 ,对患者预后有重要参考价值。

Relation of p53, bcl-2 and nm23 Protein Expression to the Biological Characteristics of Gastric Cancer

Objective To study the relationship between the expression of p53,bcl-2 and nm23 and clinicopathology in the patients with gastric cancer and to probe the correlation among the expression of three kinds of oncogene. Methods Eighty cases of different differentiated gastric cancer, 37 cases of peri-tumor atypical mucosa hyperplasia and 20 cases of normal gastric mucosa were stained by immunohistochemistry (SP method).The expression of p53,bcl-2 and nm23 was analyzed with their relation to histologic type,differentiation,lymph node metastasis and prognosis of gastric carcinoma. Results The positive rates of bcl-2 protein expression in mild,middle and severe peri-tumor atypical hyperplasia were 7.1 % , 18.1 % and 25.0 % . There was no obvious difference among 3 groups ( P > 0.05). The bcl-2 positive rates of well-differentiated and poor-differentiated gastric cancer were 78.2 % and 48.5 % respectively, the difference was obvious ( P < 0.05). The positive expression rate of p53 protein in well-differentiated gastric cancer was 72.5 % , obviously lower than that of poor-differentiated gastric cancer (86.2 % , P < 0.05). The positive rate of nm23 in well-differentiated gastric cancer was 84.3 % , obviously higher than that of poor-differentiated (17.2% ),and the expression rate of non-lymph node metastasis group was higher than that of lymph node metastasis group ( P < 0.05). The expression rate of nm23 protein was closely correlated to tumor differentiation and lymph node metastasis ( P < 0.05). There was a negative correlation between p53 and bcl-2 expression. Conclusion bcl-2 and p53 can be important indices for tumor differentiation and prognosis. nm23 protein plays an important inhibiting role in the process of gastric cancer metastasis and may be a molecular biological basis for the evaluation of patients prognosis in gastric cancer.