p21、p27和bcl-2在大肠癌、大肠腺瘤及正常大肠黏膜中表达的意义及相关性研究

目的：探讨p21、p27、bcl-2蛋白在大肠癌、大肠腺瘤及正常大肠黏膜中的表达及其临床意义。方法：采用免疫组化方法，分别检测20例正常大肠黏膜、22例大肠腺瘤和69例大肠癌中p21、p27、bcl-2蛋白表达情况。结果：p21、p27、bcl-2蛋白总阳性表达率分别为44．93％、50．72％、52．17％，各种蛋白的阳性表达率在大肠癌组织与对照组间存在的差异有统计学意义（p〈0．05）。其中发生淋巴结转移的大肠癌组织中p21阳性表达率高于无淋巴结转移的大肠癌组织中的阳性表达率，差异具有统计学意义（P〈0．05）；p27蛋白的表达与肿瘤分化程度呈负相关（P〈0．05）；在发生淋巴结转移的大肠癌组织中bcl-2阳性表达率低于无淋巴结转移的大肠癌组织中的阳性表达率，差异具有统计学意义（P〈0．05），高分化、中分化腺癌与低分化腺癌相比，差异均有统计学意义（P〈0．05），TNMⅣ期bcl-2表达率显著低于Ⅰ、Ⅱ、Ⅲ期（P〈0．05）。结论：p21、p27、bcl-2蛋白与大肠癌的发生、发展有密切关系，联合检测p21、p27、bcl-2对于临床诊断大肠癌及判断病情、预后有重要意义。

Study of expression of p21, p27, bcl-2 in colorectal carcinoma, adenoma and normal tissues

Objective：To investigate the relationship between the expression of p21, p27, bcl-2 in the normal colorectal mucous membrane, colorectal adenoma ,carcinoma and clinicopathologic features. Methods：The expression of p21, p27, bcl-2 was detected respectively in 69 patients with colorectal carcinoma, 22 with colorectal adenoma and 20 normal colorectal mucous membrane by the immunohistochemical staining. Results：The frequency of p21, p27, bcl-2 staining in carcinoma tissues is 44.93%,50.72%,52.17%, respectively, being significantly difference in positive rates of these protein of control sample （P〈0.05）. The positive rate of p21 immunostaining was 70.83% in patients with lymphytic metastasis being significantly higher than that of in patients without lymphytic metastasis 31.11%（P〈0.05）. A statistically significant difference in p27 staining was found in relation to the histologic grade （P〈0.05）. The positive rate of bcl-2 immunohistochemical staining was 33.33% in patients with lymphytic metastasis, compared with 62.22% in patients without lymphytic metastasis （P=-0.022 1）. A statistieally significant difference in bcl-2 staining was found in relation to the histologie grade （P〈0.05）. Staining frequency for bcl-2 in TNM Ⅳ was signifieantly lower than those of TNM Ⅰ, Ⅱ, Ⅲ （P〈0.05） . Conclusion：The results suggest that p21, p27, bcl-2 protein have relations with the genesis and development of coloreetal carcinoma. The detection for these proteins will play an important part in clinical diagnosis and prognosis.