胆囊良恶性肿瘤中P16蛋白表达及临床意义_0.docVIP

胆囊良恶性肿瘤中P16蛋白表达及临床意义 【摘要】 目的 探讨胆囊良恶性肿瘤中P16蛋白表达与临床病理特征的关系。 方法 采用免疫组化Envision二步法，检测46例胆囊癌，20例胆囊腺瘤的表达水平，并用24例正常胆囊黏膜作对照。 结果 P16蛋白在胆囊癌中的阳性表达率53.0%，明显低于胆囊腺瘤（90.0%）及正常黏膜（92.1%），P＜0.05。在胆囊癌的低分化组低于高、中分化组，在S4～S5期低于S1～S2期，其组间比较均差异有显著性，P＜0.05。 结论 P16蛋白在胆囊良恶性病变中表达与胆囊癌的病理分型、分化程度及Nevin分期均有密切相关，提示该项指标可作为胆囊良恶性肿瘤的鉴别诊断与胆囊癌的预后判断指标之一。 　　【关键词】 胆囊腺瘤；胆囊癌；P16基因；免疫组化 　　To study the expression of p16 protEin and discuss its clinical significance in benign and malignant gallbladder tumors 　　【Abstract】 Objective To discuss the expression of p16 protEIn and its clinical pathological characteristics in the benign and malignant gallbladder tumors. Methods p16 protein was detected in 46 cases of gallbladder carcinoma, 20 cases of gallbladder adenoma, 24 cases of normal gallbladder mucosa with immunohistochemical Envision. Results The positive rates of p16 protein were 53.0%, 90.0% and 92.1% in gallbladder carcinoma, gallbladder adenoma, normal gallbladder mucosa respectively. The positive rate of p16 protein in gallbladder carcinoma was higher than those in gallbladder adenoma and normal gallbladder mucosa (P0.05). The positive rate of p16 protein in low differentiation group was significantly lower than those in middle and high differentiation groups in gallbladder carcinoma (P0.05). The positive rate of p16 protein in S4-S5 phase was significantly lower than those in S1-S2 phase in gallbladder carcinoma (P0.05). Conclusions The expression of p16 protein was related to benign or malignant, pathological types, differentiation and Nevin phase in gallbladder tumors. P16 protein may be an indication of diagnosis and prognosis in gallbladder carcinoma. 　　【Key words】 gallbladder adenoma； gallbladder carcinoma； p16 protein； immunohistochemistry 　　P16基因是多重肿瘤的抑制基因（MTS1），位于人类染色体qp21区位上，全长为8.5kb,其编码分子量为15.84kD的蛋白质P16，P16基因是一种CDKS抑制蛋白基因，其表达蛋白通过与CDK4的特异的结合来抑制该蛋白激活酶的活性，阻止细胞从G1期到S期，从而抑制细胞增殖［1］。当其发生突变或缺失时，调控细胞周期的抑制因子P16不能正常表达，导致细胞增殖失控，而发生肿瘤形成［2］。本文探讨其P16蛋白表达与胆囊肿瘤的发生、 发展 关系及临床病理特征。 　　1 材料与方法 　　1．1 材料 　　由上海市瑞