家族性腺瘤性息肉病肠粘膜、腺瘤及癌组织的基因蛋白检测与意义

研究家族性腺癌性息肉病（FAP）癌变过程中P21－H－ras、EGFR和P53的变化与意义。方法：用ABC免疫组化方法检测并比较以上三种指标在41例FAP患者的正常肠粘膜、腺瘤和癌组织标本中表达情况。结果：P21－H－ras、EGFR及P53在正常肠粘膜中阳性表达率分别为0、4．7％与0，在腺癌中为29．3％、35．4％与20．8％，癌组织中为47．4％、60．6％与52．6％，癌与腺癌的阳性率都显著高于正常肠粘膜（P＜0．05）；P21－H－ras、EGFR在癌组织中的阳性率高于腺瘤，但差别不显著（P＞0．05），P53在癌的阳性率显著高于腺癌（P＜0．05）。癌组织有2个以上指标阳性者占55．6％，3个都阳性者占27．3％；腺瘤中分别为13．2％与4．4％，差别显著（P＜0．05）。结论：提示P21－H－ras、EGFR、P53基因都参与FAP癌变，P21－H－ras基因、EGFR可能作用于早期，P53基因则作用于晚期。检测P21－H－ras、EGFR、P53对早期诊断FAP癌变有一定意义。

Examination and Significance of Expression of Oncogene Proteins in the Colorectal Normal Mucosa, Adenoma and Carcinoma from Patients with Familial Adenomatosis Polypesis

Objective:To study the expression and significance of P21-H-ras,EGFR and P53 in the colorectalnormal mucosa,adenoma and carcinoma. Methods: Expression of P21-H-ras,EGFR and P53 in colorectal normalmucosa, adenoma and carcinoma from 41 cases of patients with FAP was examined by ABC immunohistochemistry. Results: ThepositiveratesofP21-H-ras, EGFRandP53were 0, 4. 7 % and Oinnormalmucosa, 29. 3%,35. 4% and 20. 8% in adenoma, 47. 4%, 60. 6 % and 52. 6% in carcinoma respectively. The positive rates in carcinoma and in adenoma were all significantly higher than those in normal mucosa (P0. 05 ). Thepositive rate of P53 in carcinoma was significantly higher than that in adenoma(p<0. 05). There were 27. 3%samplesofcarcinoma with all three marks postive and 55. 6 % at least two marks postive, but only 4. 4 % and 13. 2 %in adenoma. The differences in postive rates between carcinoma and adenoma were significantely (P<0. 05).Conclusion :The results indicate that P21-H-ras,EGFR and P53 are involved in the carcinogenesis of FAP,P21 H-ras and EGFR may be in the early stage,and P53 may be in the late stage. It may be useful to examine the expression of P21-H-ras,EGFR and P53 for the early detection of carcinoma in patients with FAP.