肾盂输尿管癌p53、nm23表达的临床意义

目的：揭示p53、nm23基因表达与肾盂输尿管癌生物学行为的关系。方法：采用免疫组化SABC法和原位杂交技术检测p53、nm23的表达。结果：肾盂输尿管癌p53、nm23阳性表达分别为51．1％（23／45）和46．7％（21／45）。p53阳性表达T2－T3为60％（21／35），T1为20％（2／10），P＜0．05；G2－G3为59．0％（23／39），G1为0％（0／6）。nm23阳性表达T2－T3为48．6％（17／35），T1为40％（4／10），P＞0．05，G2－G3为48．7％（19／39），G1为33．3％（2／6），P＞0．05。p53阳性表达术后再发膀胱癌与阴性表达相比较P＞0．05。nm23阳性表达术后膀胱癌再发为61．9％（13／21），阴性表达为20．9％（5／24），P＜0．05。p53、nm23阳性表达生存率明显低于阴性表达，P＜0．05。结论：p53阳性表达与肾盂输尿管癌病理分期、分级有关，nm23阳性表达与术后再发膀胱癌有关。p53和nm23可能是判断肾盂输尿管癌预后的指标之一。

Clinical Significance of p53,nm23 Expression in Renel Pelvic and Ureteral Carcinoma

Objective:Our aim was to investigate the relationship between the expression of p53,nm23 and biological progress in renal pelvic and ureteral carcinoma. Methods：The expression of p53 was detected by using immunohistochemical SABC method and the expression of nm23 was detected using in situ hybridization. Results:Positive rates of p53 and nm23 in renal pelvis and ureteral carcinoma were 51.1%(23/45),46.7%(21/45)respectively.In T2 to T3 pathological stage,p53 positive rate was 60%(21/35),while it was 20%(2/10) in T1,P<0.05.Positive rate of p53 in G1 to G2 stage was 59%(23/39),and 0%(0/6) in G1.The positive rate of nm23 was 48.6%(17/35) in T2 to T3 stage and 40%(4/10) in T1,P>0.05. In carcinoma of G2 to G3 stage,nm23 was 48.7%(19/39) positive and 33.3%(2/6) in G1,P>0.05.No significant difference was found in the incidence of multi organ urothelial carcinoma between p53,nm23 positive expression group and negative group,P>0.05. The recurrent rates of post operative bladder cancer showed no difference in group of p53 positive expression and negative expression, (P>0.05). Recurrent rate of post operative bladder cancer in nm2 positive group was 61.9%(12/21),and 20.8% in nm23 negative group,P<0.01.Survival rate in p53,nm23 positive expression group was higher than that of negative group,(P<0.01). Conclusion:Positive expression of p53 is related to pathological stage,cellular grade, and prognosis of renal pelvic and ureteral carcinoma.The expression of nm23 is related to the recurence of postoperative bladder cancer,and is helpful in predicating the recurrence of postoperative bladder cancer in renal pelvic and ureteral carcinoma.