儿童非霍奇金淋巴瘤MDM2和p53蛋白表达的研究

 目的 探讨儿童非霍奇金淋巴瘤（NHL）患者癌基因MDM2和抑癌基因p53的表达与NHL的恶性程度和预后的关系。方法 46例儿童NHL患者作为病例组，12例儿童淋巴结炎患者作为对照组。用免疫组织化学超敏S-P染色法，检测病例组NHL患者、对照组淋巴结炎患者病理组织的MDM2蛋白和p53蛋白的表达情况，阳性细胞为胞核染成黄色~棕黄色，阳性细胞数≥10 %为MDM2免疫组织化学阳性（MDM2蛋白过度表达）；阳性细胞数>5 %为p53免疫组织化学阳性。结果 病例组MDM2蛋白过度表达率为65.2 %，与对照组比较差异有统计学意义（P＜0.01）。p53蛋白阳性率为19.6 %，与对照组比较差异无统计学意义（P＞0.05）。MDM2蛋白过度表达率在病理分类高度恶性、患者血清LDH增高之间差异均有统计学意义（P＜0.05），与患者的B状态间差异有统计学意义（P＜0.01）。p53蛋白阳性率与病理工作分类、临床分期、B状态、血清LDH之间差异均无统计学意义（P＞0.05）。MDM2蛋白过度表达与p53蛋白阳性之间没有关联性。结论 儿童NHL患者MDM2基因的过度表达率较高；MDM2过度表达与儿童NHL患者的不良状况、不良预后有关；儿童NHL患者p53阳性率较低。

Relationship between the expression of MDM2 protein, p53 protein and non-Hodgkin lymphoma in childhood

Objective To investigate the relationship between the expression of MDM2 protein, p53 protein and the malignant grade as well as prognosis of non-Hodgkin lymphoma(NHL) in childhood. Methods 46 cases of NHL were chosen as patient group and 12 cases of lymphadenitis as control group. Immunohis－tochmistry ultrasensitive S-P assay was used to detect the expression of MDM2 protein and p53 protein in pathological tissues in all cases. Positive cells were dyed yellow or brown in nuclei. Positive MDM2 was that the positive cells were ≥10 % tissue cells, which was overexpression of MDM2 protein. Positive p53 was that the positive cells were >5 % tissue cells, which meant mutation of p53. Results Rate of overexpression of MDM2 protein was 65.2 %, which had remarkable significant difference as compared to that of control group (P < 0.01). Rate of positive p53 protein was 19.6 %, which was no difference as compared to that of control group (P > 0.05). Analysis of relationship to subgroup among the patients group showed that overexpression of MDM2 protein was significant interrelation to the pathologic classifications of working formulation and raised serum LDH (P < 0.05), and very significant interrelation to the classifications of B status (P < 0.01). Analysis of relationship to subgroup among the patients group showed that overexpression of positive p53 protein was no difference as compared to subgroups (P > 0.05). Positive p53 protein was not relation to overexpression of MDM2 protein. Conclusion Rate of overexpression of MDM2 protein was quite high; Overexpression of MDM2 protein was related to poor status and poor prognosis in the patients of childhood NHL; Rate of overex－pression of p53 protein was low in childhood NHL.