骨巨细胞瘤P—gp、p27kipl、p53蛋白的表达及其意义

目的 观察骨巨细胞瘤组织中P-gp、p27kip1、p53蛋白的表达情况,探讨其临床病理意义。方法 应用S-P免疫组化方法,对36例骨巨细胞瘤组织中进行了P-gp、p27kip1、p53蛋白检测。结果 36例骨巨细胞瘤P-gp阳性12例(33.3％),其中Ⅰ、Ⅱ、Ⅲ级阳性率分别为45.5％、26.6％、33.3％;初、复发瘤分别为21.4％、75％,复发瘤明显高于初发瘤,差异有显著性(P<0.01)。p27kip1阳性31例(86.1％),其中Ⅰ、Ⅱ、Ⅲ级阳性率分别为100％、94.7％、33.3％,差异有显著性(P<0.01);初、复发瘤分别为100％、37.5％,差异有显著性(P<0.005)。p53仅在Ⅲ级复发瘤中有3例阳性(8.3％)。结论 P-gp在骨巨细胞瘤中的过表达可能是肿瘤对化疗不敏感的原因之一,其表达与肿瘤病理分级无关。p27kip1的表达与骨巨细胞瘤的组织学分级、复发及预后差有关,有助于判断肿瘤的生物学行为和预后。p53的异常表达可视为肿瘤恶性的指标之一。

Expressions of P-gp,p21 kipl and p53 proteins in giant cell tumor of bone and their significances

Objective To investigate expressions of P-gp,p27 kipl and p53 proteins in giant cell tumor of bone and their clinicopathological significances.Methods P-gp,p27 kipl and p53 proteins in the tumor were examined using immunohistochemistry with S-P technique.Results Twelve of 36 cases (33.3%) in this series were positive for P-gp.The positive rates of P-gp were 45.5% ,26.6% and 33.3% in grade I , II and III of the tumor, respectively,and were 21.4% and 75% in primary and recurrent tumors,respectively,with statistically significant difference(P<0.01) .The total positive rate of p27kipl in this series was 86.1%(31/36),with percentage of 100%,94.7% and 33.3% in grade I ,II and III ,respectively(P<0.01) ,and were 100% and 37.5% in primary and recurrent tumors, respectively (P < 0.005). Only 3 cases (8.3%) were positive for p53 protein. Conclusion Overexpression of P-gp in giant cell tumor of bone may be one of the causes of insensitivity to chemotherapy, and there is no correlation between expression and histological grade of the tumor. The expression of p27kipl in the tumor is related to histological grading, recurrence and poor prognosis of the tumor. Therefore, it is suggested that the expression of p53 might be useful for prediction of the behavior and prognosis of the tumor.