膀胱移行细胞癌中Ki-67与p53及VEGF的表达及临床意义

目的：探讨膀胱移行细胞癌（TCCB）中Ki-67与p53、VEGF的表达与TCCB临床病理特征的关系及其临床意义。方法：应用免疫组织化学染色方法检测113例TCCB组织中Ki-67、p53及VEGF的表达，并将结果与临床分期、病理分级进行相关性分析。结果：TCCB中Ki-67、p53和VEGF的表达率分别为82．3％（93／113）、80．5％（91／113）、90．3％（102／113），Ki-67、p53的表达率及表达强度随着TCCB的临床分期、病理分级的升高而升高（P〈0．05），VEGF的表达率和表达强度与肿瘤的临床分期呈正相关（P〈0．05），与病理分级无显著相关性（P〉0．05）；Ki-67与p53、VEGF均呈正相关，r分别为0．240、0．239，相关性有统计学意义（P〈0．05）；在高分期、高分级组TCCB中Ki-67和p53、Ki-67和VEGF联合阳性表达率高于低分期、低分级组，差异有统计学意义（P〈0．05）。结论：Ki-67的表达与TCCB的恶性程度有关，其与p53和VEGF的过度表达对TCCB的发生、发展起着协同的作用，Ki-67与p53、VEGF的联合检测更有助于TCCB临床分期、病理分级、预后判断及术后辅助治疗方案的制定。

Expression and clinical significance of Ki-67, p53 and VEGF in transitional cell carcinoma of the bladder

Objective： To study the expression of Ki-67, p53 and VEGF in transitional cell carcinoma of the bladder （TCCB） tissue, and to investigate the relationship between the expression and clinicopathologic parame-ters in patients with TCCB. Method： The expression of Ki-67, p53 and VEGF in 113 cases of bladder cancer were assessed by immunohistochernistry, and their correlations with clinicopathological factors were statistically ana-lyzed. Result： The expression rates of Ki 67, p53 and VEGF in bladder cancer were 82.3% （93/113）, 80.5% （91/113）, 90.3% （102/113） respectively. In addition, the expression rates and intensity of Ki-67 and p53 in-creased along with the rising of clinical stage and pathologic grade （P〈0.05）. The expression of VEGF is also positively correlated with clinical stage （P〈0.05）, but not with the pathologic grade （P〉0.05）. Ki-67 was posi tively correlated with p53 and VEGF, which were statistically significant （P〈0.05）. The positive co-expression rates of Ki-67, p53 in advanced-type and high-grade group were higher than that in the early-stage and low-grade group, which the same result could be seen in the positive co-expression rates of Ki-67 and VEGF. Thus, the difference was statistically significant （P〈0.05）. Conclusion： The expression of Ki-67 was associated with the de-gree of malignancy of bladder cancer. The over expression of Ki-67, p53 and VEGF might reveal synergistic action on the course of the occurrence, development of transitional cell carcinoma of the bladder. Detecting the expression of Ki-67 as well as p53 and VEGF can better indicate the clinical stage, pathologic grade, the prognosis and pro-vide basis for postoperative adjunctive therapy.