膀胱肿瘤组织中Rb、E2F-1及P21的表达及其意义

目的：检测膀胱肿瘤组织中Rb、E2F-1及P21蛋白的表达,探讨三者在膀胱肿瘤组织发生和发展中的作用及临床价值。方法：采用免疫组织化学方法检测122例膀胱肿瘤组织中Rb、E2F-1及P21蛋白的表达。结果：在膀胱移行细胞乳头状瘤和膀胱移行细胞癌中Rb蛋白表达的阳性率分别为93.3%（28/30）和68.5%（63/92）,膀胱癌组低于乳头状瘤组,组间差异有统计学意义（P=0.007）。E2F-1、P21蛋白在膀胱癌与乳头状瘤组中阳性表达率分别为70.7%（65/92）、46.7%（14/30）和72.8%（67/92）、50.0%（15/30）,膀胱癌组高于乳头状瘤组,组间差异有统计学意义（P=0.017;P=0.021）。E2F-1和P21蛋白在膀胱癌组织中阳性表达率随组织分化程度的降低而升高。Spearman等级相关分析显示膀胱肿瘤组织中Rb与E2F-1、P21蛋白表达呈负相关（r=-1.000,P〈0.05,r=-1.000,P〈0.05）;E2F-1和P21蛋白表达呈正相关（r=1.000,P〈0.05）。结论：Rb、E2F-1及P21蛋白的表达异常可能与膀胱移行细胞癌的发生发展有关,Rb、E2F-1及P21蛋白的联合检测可为诊断膀胱移行细胞癌及临床判断组织恶性程度提供参考。

Expression of Rb,E2F-1 and P21 protein in bladder tumor and their pathological significance

Objective： To detect the expression of Rb,E2F-1 and P21 in bladder tumor and explore their role in the development of bladder tumor and clinicopathological significance. Methods： Rb,E2F-1 and P21 protein were detected by immunohistochemical method in 122 cases of bladder tumor. Results： The positive expression rate of Rb protein in bladder transitional cell papilloma and bladder cancer were 93.3%（28/30）,68.5%（63/92）,the difference was significant （P=0.007）.The positive rates of E2F-1 and P21 in bladder cancer were 70.7%（65/92）,72.8%（67/92）,which was significantly higher than 24% and 22.8%in bladder papillary epithelioma（P0.05,P0.05）.Rb negatively correlated with E2F-1（r= -1.000,P0.05）and P21（r=-1.000,P0.05）;E2F-1 positively correlated with P21 （r=1.000,P0.05）. Conclusion： The down-regulation of Rb expression and up-regulation of E2F-1 and P21 expression may contribute to the carcinogenesis and development of bladder cancer and can be a biological marker for diagnosis and judging malignancy degree of bladder cancer.