胃癌中p16、p53蛋白表达与细胞增殖、浸润、转移及预后的关系

目的　探讨 p16、p5 3蛋白表达与胃癌细胞增殖、浸润、转移及预后的关系。方法　应用免疫组化S -P法研究 10 0例胃癌 ,2 0例中、重度异型增生 ,16例萎缩性胃炎和 10例正常胃黏膜p16、p5 3蛋白和增殖细胞核抗原 (PC NA)的表达。结果　正常胃黏膜 p16阳性率为 80 % ,p5 3未表达。萎缩性胃炎、异型增生和胃癌组织中 p16阳性率分别为 68 8%、3 5 %和 4 3 % ;p5 3阳性率分别为 12 5 %、2 5 %和 5 6%。p16在胃癌中的阳性率与预后明显相关 (P<0 .0 5 ) ;p5 3阳性率与肿瘤病理分级、Lanren分型有显著相关 (P <0 .0 5 ) ,与预后关系密切 (P <0 .0 1)。从正常胃黏膜到病变组织PCNA指数逐渐上升 ,以异型增生、胃癌细胞增殖显著 (P <0 .0 1) ,癌细胞PCNA指数p16阴性组 ,p5 3阳性组高于对照组 ,与肿瘤大小、浸润深度密切相关 (P <0 .0 5 )。p16、p5 3阳性表达具有协同性 (P <0 .0 5 )。结论　胃黏膜中、重度异型增生有较高的增殖活性 ,基因水平上已表现出癌变特性 ,是癌变发生过程中的一个重要阶段。p16、p5 3蛋白表达在胃癌的发生发展中起重要作用 ,可作为判断预后的可靠指标。

RELATIONSHIP OF p16,p53 PROTEIN EXPRESSION WITH PROLIFERATION,INFILTRATES,METASTASIS AND PROGNOSIS

Objectives\ To study relationship of p16,p53 protein expression with proliferation,infiltrates,metastasis and prognosis of gastric cancer.Methods\ Using immunohistochemical method (S-P method),p16,p53 protein and proliferating cell nuclear antigen (PCNA) expressions were measured in 100 cases of gastric cancer,20 cases of moderate,severe dysplasia,10 cases of atrophic gastritis and 10 cases of normal gastric muscosa.Results\ p16 expression rate in normal gastric muscosa was 80%,p53 unexpressed.p16 expression rate of atrophic gastritis,dysplasia and gastric cancer were 68.8%\,35% and 43%,respectively,p53,12.5%\,25% and 56% respectively.The expression rate of p16 in gastric cancer was noticeably related to prognosis (P<0.05).The p53 expression rate was very significant for neoplasma pathomorphological grade and lanren type,and was closely related to prognosis (P<0.01).From normal tissue to lesion tissue,PCNA index increased gradually,expecially in dysplasia and gastric cancer cells(P<0.01).The PCNA index of cancer cells in p16 negative group and p53 positive group was higher than that of control group and closely related to tumor size and degree of infiltrating (P<0.05).p16\,p53 protein expression was synergistic (P<0.05).Conclusions\ In gastric muscosa,moderate and severe dysplasia has a higher proliferating feature and carcinogenesis on gene level,which is an important stage in carcinogenesis.The protein expression of p16 and p53 plays a significant role in gastric carcinogenesis,which is reliable indicators for prognosis.