c-erbB-2 、bcl-2和p53在结直肠肿瘤中的表达及其临床意义

背景：c-erbB-2、bcl-2和突变型p53在结直肠腺瘤癌变过程中相互调节并发挥重要作用。目的：探讨结直肠肿瘤中c-erbB-2、bcl-2和D53蛋白的表达及其临床意义。方法：取42例结直肠腺癌、10例腺瘤和10例正常结直肠黏膜组织，以免疫组化方法检测其中c-erbB-2、bcl-2和p53蛋白的表达，分析其表达与腺癌临床病理特征的关系。结果：c-erbB-2、bcl-2和p53蛋白在腺癌、腺瘤和正常黏膜组织中的表达差异均有统计学意义（P〈0．05），bcl-2蛋白在腺癌组织中的表达低于腺瘤组织，c-erbB-2和p53蛋白在腺癌组织中的表达高于腺瘤和正常黏膜组织。c-erbB-2蛋白的表达随腺癌分化程度的降低而增高，bcl-2蛋白的表达随腺癌分化程度的降低而降低：c-erbB-2和p53蛋白的表达与淋巴结转移和Dukes分期呈正相关。腺癌组织中bcl-2与p53蛋白的表达呈负相关（rs=-0．301，P〈0．05）。结论：c-erbB-2与结直肠癌的进展、分化和转移相关。腺癌组织中p53高表达和bcl-2相对低表达提示两者可能参与了结直肠癌的发生、发展过程，bcl-2过表达可能在结直肠癌发生的早期起作用。

Expression and Clinical Significances of c-erbB-2, bcl-2 and p53 in Colorectal Neoplasms

Background:c-erbB-2,bcl-2 and mutation of p53 are mutually interregulated and may play important roles in the carcinomatous changes of colorectal adenoma.Aims:To appraise the protein expression of c-erbB-2,bcl-2 and p53 in colorectal neoplasms and their clinical significances.Methods:Immunohistochemical method was used to detect the protein expression of c-erbB-2,bcl-2 and p53 in 42 colorectal adenocarcinoma,10 adenoma and 10 normal colorectal mucosal tissue.The relationships between these protein expression and the clinicopathologic characteristics of colorectal adenocarcinoma were analyzed.Results:Significant differences could be found among colorectal adenocarcinoma,adenoma and normal colorectal mucosal tissue in the protein expression of c-erbB-2,bcl-2 and p53(P<0.05).bcl-2 protein expression in colorectal adenocarcinoma was decreased as compared with that in the adenoma while the protein expression of c-erbB-2 and p53 in colorectal adenocarcinoma was increased.From well-,moderately-to poorly-differentiated adenocarcinoma of colorectum,the protein expression of c-erbB-2 increased and bcl-2 decreased gradually,and protein expression of c-erbB-2 and p53 was positively correlated with lymph node metastasis and Dukes staging of colorectal adenocarcinoma.Negative correlation was found between the protein expression of bcl-2 and p53 in the colorectal adenocarcinoma(rs=-0.301,P<0.05).Conclusions:c-erbB-2 is involved in the progression,differentiation and metastasis of colorectal cancer.High expression of p53 and relatively low expression of bcl-2 may be correlated with the occurrence and development of colorectal cancer.Over-expression of bcl-2 may be an early event in the development of colorectal cancer.