黏液表皮样癌中三种基因蛋白的表达及其意义

目的 了解p53，bcl-2和c-erbB2-蛋白在黏液表皮样癌中的分布，评价其对鉴别诊断及预后判断的意义。方法 用免疫组织化学技术检测了41例黏液表皮样癌和10例正常涎腺组织的p53,bcl-2和c-erbB－2表达。结果 c-erbB－2蛋白在正常涎腺的分布特征为导管上皮全部阳性（10／10），而腺泡上皮仅有1例阳性（1／10），黏液表皮样癌的阳性率低于正常涎腺，但阳性强度高于正常涎腺；p53蛋白在正常涎腺及黏液表皮样癌的阳性率分别为10％和51％，两者有显著性差异（P＜0．01）。而且，p53蛋白在高低分化两组黏液表皮样癌的阳性率也有差别（P＜0．05）；bcl-2在黏液表皮样癌的阳性率有高于正常涎腺的趋向。结论 在正常涎腺中c-erbB－2主要分布在导管上皮。黏液表皮样癌和正常涎腺在p53,bcl-2和c-erbB-2表达方面有一定的差异。p53阳性表达的患者多具有低分化黏液表皮样癌的病理特征，但未能发现在黏液表皮样癌表达bcl-2和c-erbB-2的预后意义。

Expression of p53, bcl-2 and c-erbB-2 in mucoepidermoid carcinoma of the salivary glands

Objective To investigate the expression of p53, bcl 2 and c erbB 2 in mucoepidermoid carcinoma (MEC) of the salivary glands, and to evaluate their significance in the differential diagnosis and prognosis of the patients. Methods Immunohistochemical technique was used to detect the oncoproteins in 41 cases of MEC and 10 normal salivary glands. Results Expression of c erbB 2 was detected in the ductal epithelia of all normal salivary glands and 85% of MEC cases, in which there was a stronger immunoactivity in the latter. The rates of p53 expression in normal saliva and MEC were 10% and 51% respectively with a statistical significance (p?0.01). There was also a significant difference (p?0.05) in p53 expression between well-differentiated MECs and poor-differentiated ones. Positive staining of bcl 2 was much easily detected in MECs than in normal saliva. Conclusions Expression of c erbB 2 is much commonly found in the ductal epithelia than acinic ones of normal salivary glands. Different expression of p53, bcl 2 and c erbB 2 are found between MECs and normal saliva. Poor-differentiated MEC is closely related to aberrant expression of p53, but no prognostic significance is found in the expression of bcl 2 and c erbB 2 in MEC cases.