肝细胞癌p53蛋白、增殖细胞核抗原与临床关系的研究

目的　探讨在肝细胞癌中突变型 p5 3蛋白与增殖细胞核抗原 (PCNA)的相互关系及其意义。 方法　应用免疫组化ABC法检测肝细胞癌和肝硬化中 p5 3蛋白及增殖细胞核抗原。 结果　 37例肝细胞癌 (HCC)中 p5 3阳性 19例 ,33例肝硬化标本中p5 3阳性 2例 ,两者有显著差异 (P <0 .0 1) ;HCC中PCNA阳性细胞均数显著高于肝硬化组 (P <0 .0 1) ;p5 3阳性者PCNA阳性细胞数高于p5 3阴性者 (P <0 .0 5 )。p5 3与PCNA两者表达存在显著正相关关系 (r=0 .5 936 2 ,P <0 .0 5 ) ,p5 3表达与年龄、性别、组织分化无关 ,PCNA表达分别与组织分化及血AFP成负相关及正相关。结论　p5 3基因突变在由肝硬化转变为癌过程中是频发事件 ,其表达异常与HCC发生密切相关。PCNA与 p5 3的正相关提示p5 3突变型主要存在于异常增生细胞中 ,且PCNA可反映癌细胞分化及增殖程度 ,可为肝硬变与肝癌关系的探讨及临床诊断、治疗、预后提供参考资料。

Expression of p53 protein and PCNA in hepatocellular carcinoma and its clinical significance

Objective To study the relationship between p53 protein and proliferating cell nuclear antigen(PCNA) and its significance in hepatocellular carcinoma. Methods The expression of p53 and PCNA in 37 cases of HCC and 33 cases of cirrhosis was examined by immunohistochemistry-ABC method. Results p53 protein was positive in 19 of 37 cases with hepatocellular carcinoma and in only 2 of 33 cases with cirrhosis respectively. The difference between them was statistically significant ( P <0.01). The number of the cells expressing PCNA in HCC was larger than that in cirrhosis ( P <0.01). The quantity of the cells expressing PCNA in cases with positive p53 protein was larger than that in the cases with negative p53 ( P <0.05). There was remarkable positive correlation between the expression of p53 and the expression of PCNA ( r=0.59362,P <0.05). There was no apparent correlation between the expression of p53 and age, gender or differentiation of tissue, while the expression of PCNA was correlated positively but negatively with differentiation of tissue and AFP level of plasma respectively. Conclusion The mutation of p53 gene was frequent in the development from cirrhosis to HCC. The positive correlation between PCNA and p53 suggests that the mutation of p53 gene appear mainly in abnormally proliferating cells and PCNA can reflect the differential and proliferating degree of cancer cells. These may provide reference materials for investigating the relationship between HCC and cirrhosis and contribute to clinical diagnosis, treatment and prognosis.