胃肠道间质瘤中PCNA和bcl2蛋白的表达及临床意义.DOCVIP

临床医学论文-胃肠道间质瘤中PCNA和bcl2蛋白的表达及临床意义 ? ??????????? 作者：陶雪勤，熊永炎，姚兴凤 【摘要】? 目的 探讨胃肠道间质瘤（gastrointestinal stromal tumor,GIST）中增殖细胞核抗原（PCNA）和bcl2蛋白的表达与其发生及恶性转化的关系。方法 采用免疫组化SP法及彩色病理图像分析系统检测68例GIST组织中PCNA和bcl2蛋白的表达。结果 68例GIST中，PCNA均呈阳性表达，其平均灰度值在良性组为144.95±3.37，潜在恶性组为139.54±4.91，恶性组为135.71±6.11，依次递减，即阳性表达水平逐渐增强，三者两两比较，差异均有显著性（P0.05）。68例GIST中，bcl2阳性表达者35例（51.47%），其平均灰度值在良性组为144.32±3.80，潜在恶性组为142.35±12.30，恶性组为140.35±12.06，三者两两比较，差异无显著性（P0.05）。GIST中PCNA和bcl2表达无明显相关性（P0.05）。结论 细胞的增殖与凋亡的失衡是GIST发生恶性转化的重要机制之一。PCNA检测有助于判断GIST的性质；bcl2在GIST早期阶段就参与了肿瘤的发生发展，但不能作为判断良恶性的指标。 【关键词】? 胃肠间质瘤；PCNA；bcl2；免疫组化；图像分析 ??? Expression of PCNA and bcl2 in Gastrointestinal Stromal Tumors ???? Corresponding Author: XIONG YongyanAbstract：Objective?? To investigate the expression of PCNA and bcl2 in gastrointestinal stomal tumors(GIST) and their correlations with the pathogenesis,development and differentiation degree of GIST.Methods? The expression of PCNA and bcl2 were detected in 68 cases of GIST by immunohistochemical technique.Futhermore,multifunction precise colorimage measure system was used for quantitative analysis.Results? All cases were positive for PCNA,the average gray in benign,potentially malignance and malignance were 144.95±3.37、139.54±4.91、135.71±6.11 respectively,there was a significant difference among the groups(P0.05).Among 68 GISTs,35 cases expression bcl2,the average gray in benign,potentially malignance and malignance were 144.32±3.80、142.35±12.30、140.35±12.06 respectively,but there was no significant difference among the groups(P0.05).There was no significant correlation between PCNA and bcl2(P0.05).Conclusion? The unbalance of the cell proliferation and apoptosis is one of important mechanism in differentiation degree of GIST.The expression of PCNA is an important predicting maker for differentiation degree of GIST,but bcl2 protein is not. ??? Key words：Gastrointestinal stromal tumor; PCNA; bcl2; Immunhistochemisty; Image analysis ??? 胃肠道间质瘤（gastrointestinal stromal