p73蛋白在原发性胆囊癌中的表达及意义

目的 研究p73蛋白在原发性胆囊癌中的表达并探讨其与肿瘤生物学行为、预后的关系。方法 应用免疫组化S-P法检测p73蛋白在49例原发性胆囊癌、15例胆囊腺瘤性息肉和12例慢性胆囊炎组织中的表达。结果 p73蛋白在原发性胆囊癌中的阳性表达率为49％(24/49),而在胆囊腺瘤性息肉和慢性胆囊炎中均无表达,具有显著差异(P<0.01)。胆囊癌组织中p73蛋白表达与肿瘤分化程度有关,在低分化癌中有较高表达,与高中分化癌比较,差异有显著性(P<0.05)。与性别、年龄、淋巴结有无转移和Nevin分期无关(P>0.05)。与预后有关,p73蛋白表达阴性病人预后显著优于p73蛋白表达阳性病人,术后1年内死亡者p73阳性表达率为68％(21/31),1～3年死亡组为25％(3/12),而>3年死亡组为0,差异有显著性(P<0.05)。结论 p73蛋白在原发性胆囊癌组织中呈高水平表达,p73基因可能参与了胆囊癌的发生、发展过程,可作为判断原发性胆囊癌分化程度和预后的指标。

Expression of p73 Protein in Primary Carcinoma of the Gallbladder and its Significance

Objective To investigate the expression of p73 protein in primary carcinoma of the gallbladder and explore its relation to biological behavior and prognosis of the tumor. Methods The expression of p73 protein in 49 cases of gallbladder carcinoma, 15 cases of adenomatoid polyp of the gallbladder and 12 cases of chronic cholecystitis was detected by using S-P immunohistocbemical method. Results The expression of p73 protein was not positive in adenomatoid polyp of the gallbladder and chronic cholecystitis, but positive expression rate was found in 49% (24/49) of primary carcinoma of the gallbladder. The p73 protein expression was significantly higher in primary carcinoma of the gallbladder than that of adenomatoid polyp of the gallbladder and chronic cholecystitis (P<0.01). p73 protein was markedly correlated to tumor differentiation (P<0.05), but no to tumor lymph node metastasis, Nevin staging and distant metastasis) (P>0.05). Meanwhile, it was correlated to postoperative survivals. Positive rate of p73 was 68% (21/31) in 1 postoperative survival year, 25% (3/9) in 1 to 2 postoperative survival years and that of 0 in more than 3 survival years (P<0.01). Conclusion p73 protein is overexpressed in primary carcinoma of the gallbladder. p73 gene may play an important role in oncogenesis and can be used as an indicator to judge differentiation and prognosis of the primary carcinoma of the gallbladder.