食管鳞状细胞癌形态发生中P53蛋白的积聚

采用ＣＭ—１和ＤＯ—７抗体免疫组化法，检测高发区河南省４３例食管鳞状细胞癌中的Ｐ５３蛋白积聚。在２６例中见ＣＭ—１阳性细胞（６０．５％）．３４例中有ＤＯ—７阳性细胞（７９．１％）．证实Ｐ５３蛋白积聚是食管鳞癌中一种常见的现象。虽然各例中表达Ｐ５３的癌细胞百分率差异甚大，但是大多数食管鳞癌都具有Ｐ５３阳性的细胞群体，而且阳性细胞多见于肿瘤活跃增生区。因此，作者认为食管鳞癌中Ｐ５３蛋白积累可能大多由于Ｐ５３基因突变所致。值得注意的是，Ｐ５３阳性细胞也可以经常在瘤旁增生，异型增生和原位癌灶中见到，其百分率随着病灶中细胞异型性的程度而逐渐增加。因此作者认为，食管鳞癌细胞中Ｐ５３基因的突变可能发生在癌前病变阶段。除此以外，绝大多数Ｐ５３阳性细胞经常也呈增殖细胞核抗原阳性，两种抗原表达的等级呈正相关。因此，免疫组化检测到的Ｐ５３蛋白积聚的食管鳞癌显示更加活跃的增生，可能具有影响患者预后的意义。

P53 PROTEIN ACCUMULATION IN MORPHOGENESIS OF ESOPHAGEAL SQUAMOUS CELL CARCINOMA

The P53 protein accumulation was detected immunohistochemically in 43 esophageal squamous cell carcinomas(ESCCs)from a high-incidence area in Henan province by use of CM-1and DO-7 primary antibodies respectively.The definitely positive cells with nuclearyellowish brown granules were found in 26 ESCCs for CM-1(60.5%) and 34 for DO-7 (79.1%),confirming that the P53 protein accumulation was a frequent finding in ESCC.Though the percentage of tumour cells expressing P53 varied greatly between different cases,the majority of ESCCs showed a predominant P53 positive cell population after all,and the positive cells were more likely to be found in the actively proliferating areas of the tumours,Thus,the authors assume that the P53 protein accumulation in ESCCs mightchiefly be resulting from p53 gene mutations. Worthy to be noted is that the P53 positive cell could also frequently be found in paratumourous hyperplasia,dysplasia and carcinoma in-situ foci,and the percentage was gradually increasing by the degree of cell atypia found within the above lesions. So, the authors suggest that the event of the p53 gene mutations in ESCCs might be developed before the malignant conversion of esophageal epithelium. In addition,the vast majority of P53 positive cells were always proliferating cell nuclear antigen(PCNA)positive and the ranks of these two kinds of antigenic expression were positively correlated.So,the ESCCs with immunohistochemically detectable P53 protein accumulation behave more active proliferation and could potentially be of prognostic importance.