膀胱尿路上皮癌中TBX2与MDM2蛋白的表达及临床意义

目的研究膀胱尿路上皮癌中TBX2、MDM2蛋白的表达与膀胱尿路上皮癌患者各临床病理因素之间的关系。方法采用免疫组织化学Envision^TM二步法检测90例膀胱尿路上皮癌和20例正常膀胱黏膜组织中TBX2、MDM2的表达情况。结果在正常膀胱黏膜组织中TBX2、MDM2蛋白的表达阳性率为0，在膀胱尿路上皮癌中，TBX2的阳性率为65．6％（59／90），随着TBX2表达程度的增高，癌组织的分化程度越低、临床分期越晚、更易出现复发（P〈0．01）。MDM2的阳性率为31．1％（28／90），随着癌组织分化程度的降低，MDM2的阳性率升高（P〈0．01）；出现复发的膀胱尿路上皮癌中MDM2的阳性率为57．5％（23／40），无复发的膀胱尿路上皮癌中，MDM2的阳性率仅为10．0％（5／50），两者差异有统计学意义（P〈0．01）。pTNM分期Ta～T1期MDM2阳性率为0（0／52），T2～T3期MDM2阳性率为73．7％（28／38），MDM2阳性患者pTNM分期更晚（P〈0．01）。癌组织中TBX2的表达与MDM2呈正相关（r=0．487，P〈0．05）。结论TBX2及MDM2在膀胱尿路上皮癌中的高表达与肿瘤的侵袭及复发有关。

Expressions and significances of TBX2 and MDM2 protein in urothelial carcinoma of bladder

Objective To evaluate the expressions of TBX2 and MDM2 protein in urothelial carcinoma of bladder. Methods The expressions of TBX2 and MDM2 protein were examined by immunohistochemistry EnvisionTM Plus method in 90 cases of urothelial carcinoma of bladder and 20 cases of normal bladder mucosa tissue. Results The positive rate of TBX2 and MDM2 protein was 0 in normal bladder mueosa tissues. The positive rate of TBX2 in urothelial carcinoma of bladder was 65.6% （59/90）. With the increased of TBX2 expression degree, the carcinoma tissue was worse cell differentiation,later clinical stage, more prone to recurrence （P 〈 0.01 ）. The positive rate of MDM2 in urothelial carcinoma of bladder was 31.1%（28/90）. With the decreased of carcinoma tissue differentiation degree, the positive rate of MDM2 was increased （P 〈 0.01 ）. The positive rate of MDM2 in recurrence patients was 57.5% （23/40）, in non-recurrence patients was 10.0% （5/50）, there was statistical difference （P 〈 0.01 ）. The positive rate of MDM2 in pTNM stage Ta-T1 was 0,in pTNM stage T2 -T3 was 73.7% （28/38）,there was statistical difference （P 〈 0.01 ）. There was positive correlation between the expression of TBX2 and MDM2 in carcinoma tissue （r = 0.487, P 〈 0.05）. Conclusions The over expression of TBX2 and MDM2 protein may closely associated with aggressive biological behavior and recurrence in urothelial carcinoma of bladder. Combined analysis of TBX2 and MDM2 may provide a theoretical basis for prognostic information and treatment of patients with urothelial carcinoma of bladder.