胃上皮异型增生并结肠及小肠上皮化生中p53、Cdk4和Survivin的表达的意义

目的 探讨胃上皮异型增生上皮并结肠及小肠上皮化生组织中p53、Cdk4和Survivin表达的意义。方法应用组织化学法和免疫组织化学sP法检测44例结肠性化生（其中低度异型增生27例，高度异型增生17例）和51例小肠性化生（其中低度异型增生42例，高度异型增生9例）胃活检组织中p53、Cdk4和Survivin的表达。结果p53、Cdk4和Survivin蛋白在胃上皮异型增生并结肠性化生与小肠性化生间的表达率有显著性差异。低度异型增生和高度异型增生间p53和Survivin蛋白表达率有显著性差异。Cdk4低度异型增生和高度异型增生间表达无显著性差异。结论p53、Cdk4和Survivin基因的改变不仅与肠上皮化生的类型有关，而且与胃上皮异型增生的程度密切相关。p53、Cdk4和Survivin蛋白可作为判断胃异型增生上皮并肠上皮化生生物学行为有价值的指标。

Expression of p53, Cdk4 and Survivin in gastric epithelial dysplasia with colonic and small intestinal metaplasia

Objective To evaluate the significance of p53,Cdk_4 and Survivin in gastric epithelial dysplasia with colonic and small intestinal metaplasia.Methods Immunohistochemical SP method was used to detect p53,Cdk_4,and Survivin in 44 cases of colonic intestinal metaplasia(27 low grade epithelial dysplasia,17 high grade epithelial dysplasia) and 51 cases of small intestinal metaplasia(42 low grade epithelial dysplasia,9 high grade epithelial dysplasia) by endoscope.Results The positive expression rates of p53 and Survivin had significant difference in two types of intestinal metaplasia and the difference was significant between low-grade and high-grade epithelial dysplasia.The expression of CDK_4 had significant difference in two types of intestinal metaplasia and had not difference between low-grade and high-grade epithelial dysplasia.Conclusion The expressions of p53,CdK_4 and Survivin are closely associated not only with the types of intestinal metaplasia but also with the different grades of epithelial dysplasia.The expression of p53,Cdk_4,and Survivin may be valuable markers in assessing the biological behavior of gastric epithelial dysplasia with intestinal metaplasia.