组织芯片技术在胃癌p53蛋白表达研究中的应用

目的探讨组织芯片免疫组化标记结果的可靠性，研究p53表达与胃癌临床病理特征及预后的相关性。方法将100例无术前放化疗史的胃癌手术标本和30例对照组胃粘膜制成组织芯片后，用免疫组化方法分别在组织芯片和常规切片上检测p53蛋白的表达，比较其差异；用TUNEL法进行细胞凋亡指数检测。对随访14个月至13年的47例作生存分析。结果共获得2个组织芯片蜡块。p53检测在常规切片和组织芯片同为阳性或同为阴性者占98％，不一致者占2％。p53表达在胃癌不同组织学分化、UICC分期和血管／神经侵犯、淋巴结转移中均有差异，但无统计学意义（P〉0．05）。p53表达与细胞渊亡指数呈负相关，但差异无统计学意义（P〉0。05）。随访结果生存分析显示，p53表达与预后无关，UICC分期具有独立的预后意义。结论组织芯片和常规切片免疫组化结果有较好的一致性。组织芯片技术是病理学研究中的高效、快速工具。p53表达与胃癌预后无显著相关性，UICC分期仍然是胃癌的独立预后指标。

The Study of Expression of p53 and Its Signification in Gastric Adenocarcinoma Using Tissue Microarrays

Objective To explore the credibility of expression of p53 in gastric carcinoma by using tissue microarrys compared with those by using conventional technique.And relationship between p53 expression and the clinicopathologic features and prognosis of gastric carcinoma was also studied.Methods The gastric cancer tissue microarrays were composed of those from 100 cases of adenocarcinoma of the stomach without a history of chemo-radiation therapy and 30 gastric tissues of control subject.p53 expression was investigated immunohistochemically in the tissue microarrys and in conventional sections.The difference of these subjects was analyzed.Tumor cell apoptosis was also examined by TUNEL method.Of the 100 cases,47cases were followed-up from 14 months to 13 years,in which the prognosis was analyzed.Results Two paraffin-embedded gastric carcinoma tissue microarrays were successfully constructed.Immunohistochemical analysis showed that p53 expression which was identical accounted for 98% in the tissuechips and in the conventional section.The p53 expression was associated with histological grades,invading of vessel & nerve, lymph node involvement,UICC stages and AI,but the difference was not significant.The followed-up data analysis showed that the survival rate was correlated with UICC staging but unrelated to p53.Conclusions Tissue microarray technique is a credible and useful method for pathologic research.p53 expression is unrelated to prognosis in gastric carcinoma.UICC staging retained significant independently in prospecting prognosis.