p53、c-erbB-2、PCNA和EGFR在膀胱癌中过表达及其意义

目的：研究癌基因和抑癌基因蛋白产物在膀胱移行细胞癌中异常表达与病理分级、临床分期、复发和预后的关系。方法：应用免疫组化Ｓ－Ｐ法检查１１７例膀胱移行细胞癌组织中ｐ５３、ｃ－ｅｒｂＢ－２、ＰＣＮＡ和ＥＧＦＲ的表达水平。结果：１１７例膀胱移行细胞癌中ｐ５３、ｃ－ｅｒｂＢ－２、ＰＣＮＡ和ＥＧＦＲ阳性表达率分别为４７．０％、２９．９％、５３．８％和４８．７％。ｐ５３和ＰＣＮＡ阳性表达产物定位于肿瘤细胞核内，ｃ－ｅｒｂＢ－２阳性表达产物定位于细胞膜上，ＥＧＦＲ阳性表达产物定位于细胞膜或细胞浆内。结果表明ｐ５３、ｃ－ｅｒｂＢ－２、ＰＣＮＡ和ＥＧＦＲ异常表达与膀胱癌的分级、分期、复发及术后生存率等之间有统计学意义。结论：ｐ５３、ｃ－ｅｒｂＢ－２、ＰＣＮＡ和ＥＧＦＲ异常表达有助于评估膀胱癌预后，多基因异常表达作为预后评价指标更有意义。

Expressions of p53, c erbB 2, PCNA and EGFR in transitional cell carcinoma of urinary bladder and their significances

Purpose To study the correlation of oncogene and antioncogene protein expression in transitional cell carcinoma of the urinary bladder and their significances to histopathological grading, clinical staging, recurrence rate and prognosis of this cancer. Methods The S P immunohistochemical staining method was used to evaluate the positivity of p53, c erbB 2, PCNA and EGFR in 117 cases of transitional cell carcinoma of the bladder. Results The positive rates of these four expression products were as follows: 47%(p53), 29 9%(c erbB 2), 53 8%(PCNA) and 48 7%(EGFR). The positively expressed products of p53 and PCNA were both located in tumor cell nuclei, while that of c erbB 2 was located on tumor cell membrane and that of EGFR was located either on tumor cell menbrane or in the cytoplasm. These expression products of p53, c erbB 2, PCNA and EGFR were found to be positively correlated to: (1) the degree of differentiation, (2) the clinical staging, (3) the postoperative five year survival rate and (4) the recurrence rate of these bladder cancers. Conclusion To evaluate of the prognosis of bladder carcinomas the positive expressions of products from multiple genes are more significant than that from a single one.