膀胱移行细胞癌组织ΔNp63和MDM2蛋白表达及意义_医学论文.docVIP

膀胱移行细胞癌组织ΔNp63和MDM2蛋白表达及意义_医学论文 膀胱移行细胞癌组织ΔNp63和MDM2蛋白表达及意义_医学论文 【摘要】 目的 探讨缺乏酸性N端反式激活区的截短型p63（ΔNp63）和MDM2蛋白在膀胱移行细胞癌（TCC）组织中的表达及其临床意义。方法 用免疫组织化学法，检测35例石蜡包埋TCC组织标本中ΔNp63和MDM2的表达，以38例正常膀胱黏膜作为对照。结果 膀胱癌组30例(83.3%)ΔNp63蛋白呈阳性表达，膀胱黏膜组7例(18.4%)呈阳性表达，两组比较差异有显著性（uc=5.75，0.01）。膀胱癌组15例(42.9%)MDM2蛋白呈阳性表达，膀胱黏膜组3例(7.9%)呈阳性表达，两组差异有显著性（χ2＝11.99,0.01）。在不同病理分级、临床分期TCC中，ΔNp63表达差异有显著性（H=21.09、14.99,0.01）。随着TCC病理分级、临床分期升高，ΔNp63表达明显增强，呈显著正相关（r=0.64、0.51,0.01）。在不同病理分级、临床分期TCC中， MDM2表达差异有显著性（χ2＝16.63,0.01；χ2＝6.72,0.05）。30例ΔNp63蛋白阳性表达TCC组织中MDM2蛋白阳性表达10例（33.3%），两者呈显著相关性（χ2=7.78，0.05）。ΔNp63阳性表达主要集中在低分化、浸润性TCC中，而MDM2则主要表达在高分化、浅表TCC中。结论 ΔNp63和MDM2与膀胱肿瘤的发生发展密切相关，可作为膀胱肿瘤早期诊断和判断恶性程度的参考指标。 【关键词】 膀胱肿瘤 ΔNp63 MDM2 免疫组织化学 ［ABSTRACT］ObjectiveTo explore the expression of ΔNp63 and MDM2 proteins in bladder transitional cell carcinoma (TCC) and its significance.MethodsImmunohistochemical method was used to detect the ΔNp63 and MDM2 expression in 35 TCC and 38 normal transitional epithelium samples.ResultsThe positive rates of ΔNp63 and MDM2 expression in TCC were 83.3% and 42.9%, respectively in the normal control, the positive rates of ΔNp63 and MDM2 expression were 18.4% and 7.9% (χ2=11.99,0.01). The positive expression of ΔNp63 in poorly differentiated and advanced TCC was significantly higher than well differentiated and superficial TCC (H=21.09,14.99；0.01). The positive rate of MDM2 expression in well differentiated and superficial tumor was significantly higher than poorly differentiated and advanced tumor (χ2=6.72,16.630.05,0.01). There was a negative correlation between the expression of ΔNp63 and MDM2. ConclusionΔNp63 and MDM2 protein expression were involved in the occurrence and progress of urinary bladder TCC, which can be used for early diagnosis and judgement of the malignancy level of this cancer. ［KEY WORDS］bladder neoplasms ΔNp63 MDM2 immunohistochemistry 膀胱肿瘤是人类泌尿系统最常见的恶性肿瘤，其发病率呈增高趋势。近年关于癌基因的研究成为热点。为研究膀胱移行细胞癌（TCC）发生发展规律，本文应用免疫组化技术分别检测TCC组织中ΔNp63和MDM2的表达，探讨其在膀胱肿瘤发生发展中的作用及临床意义。 1 对象和方法