胆道肿瘤组织中p62和p21表达的临床意义

目的 探讨原癌基因C－myc,H-ras蛋白产物P62和P21在胆管癌、胆囊癌和胆道胆囊良性病变中的表达及其临床意义。方法 应用免疫组织化学方法（ABC法），检测30例胆管癌，28例胆囊癌和30例胆道良性病变中P62和P21的表达水平。结果 30例胆管癌中，P62和P21过度表达阳性主分别为66.7%和63.3%,而胆管良性病变阳性率分别为10％和0，二者差异有显著性意义（P＜0.05),28例胆囊癌中，P62和P21过度表达阳性率,分别为42.8%和57.1%，而胆囊良性病变仅为10％和5％。二者差异比较有显著意义（P＜0.05)。同时也显示，胆管和胆囊恶性病变中P62和P21过度表达程度与病理组织学相一致，与原发癌灶的大小、淋巴的转移有显著相关性。结论 胆管癌、胆囊癌中P62和P21水平呈现过度表达，与病理类型、恶性程度、癌灶大小及淋巴转移有关，对其诊断、鉴别诊断及预后的判断有一定的参考价值。

Expression and clinical significance of P62 and P21 in bile duct and gallbladder carcinomas

Objective To investigate the expression of P62, a oncogene C myc product, and P21, a oncogene H ras product, in bile duct and gallbladder diseases and explore its clinical significance. Methods The expression of P62 and P21 was detected with immunohistochemistry in 30 cases of cholangiocarcinoma, 28 cases of gallbladder carcinoma and 30 cases of benign bile duct and gallbladder diseases. Results The rates of over expression of P62 and P21 in the 30 cases of cholangiocarcinoma were 66.7% and 63.3%, respectively, but 10% and 0% in cases of benign bile duct diseases. There was a significant difference between these 2 groups of patients (P<0.05). The rates of over expression of P62 and P21 in 28 cases of gallbladder carcinoma were 42.8% and 57.1%, respectively but 10% and 5% in cases of benign gallbladder diseases. There was also a significant difference between these 2 groups of patients (P<0.05). In the cases of bile duct and gallbladder carcinomas, the degree of the over expression of P62 and P21 was consistent with pathohistological features of the tumors and closely correlated to the size of the primary lesion and the position of lymph metastasis. Conclusions P62 And P21 are over expressed in bile duct and gallbladder carcinomas. They are related to the pathological type, malignancy, focal size and lymph metastasis of the tumors. Therefore, they are of certain reference value in diagnosis, differential diagnosis and judgement of prognosis of the tumors.