膀胱癌细胞凋亡及MDM2及P53基因表达意义.docVIP

膀胱癌细胞凋亡及MDM2及P53基因表达意义 　 作者：杨承纲，张丽娟，李梅，陈芸 【关键词】 膀胱肿瘤；P53基因；MDM2基因；免疫组织化学；细胞凋亡 ［摘 要］ 目的：研究膀胱癌细胞凋亡、MDM2、P53基因表达的意义。方法：采用免疫组织化学方法及TUNEL法检测11例“正常膀胱黏膜”和83例膀胱移行细胞癌中MDM2、P53基因的表达及细胞凋亡指数。结果：P53阳性率为50.6%,MDM2阳性率为59.03%，AI=1.433 5±0.386 3。MDM2阳性表达与病理分级及临床分期呈负相关(R=-0.263,P=0.016及R=-0.388,P=0.001);P53阳性表达与病理分级及临床分期呈正相关(R=0.492,P=0.001；R=0.341，P＜0.01);MDM2、P53三种蛋白间表达无相关性；AI与MDM2呈负相关（R=-0.226,P=0.042）；AI与病理分级及临床分期呈正相关(R=0.642,P=0.000；R=0.455，P=0.000)；AI与P53无相关性。AI、P53、MDM2的表达与5 a生存率有关。结论：联合运用临床分期及病理分级并检测P53、MDM2可用于判断膀胱移行细胞癌的预后。 　　［关键词］ 膀胱肿瘤；P53基因；MDM2基因；免疫组织化学；细胞凋亡 　　Clinical Significance of Expression of MDM2 P53 Protein and Apoptosis in Bladdercancer 　　Abstract：Objective To investigate the expression of MDM2 Pgp protein and apoptosis and its significance in bladder cancers.Methods Apoptosis Index(AI) was assessed with TUNEL technique,and immunohistochemical stainings of MDM2 and Pgp were performed in 83 cases of the carcinomas and 11 “normal” bladder mncosa.Results The positive expression rate of P53 gene was 50.6% and MDM2 was 59.03%,and AI=1.433 5±0.386 3.The level of MDM2 was negative correlated with the tumor pathological grade and clinical stage(R=-0.263,P=0.016及R=-0.388,P=0.001);The level of P53 was positive correlated with the tumor pathological grade(R=0.492,P=0.001);No correlated was found between MDM2 and P53 gene;The level of AI was negative correlated with MDM2(R=-0.226,P=0.042);The level of AI was positive correlated with the tumor pathological grade and clinical stage (R=0.642,P=0.000；R=0.455，P=0.000);The level of AI was no correlated with P53.AI and the expression of P53 and MDM2 were related to 5year survival rate.Conclusion By exerting the tumor pathological grade and clinical stage and detecting P53 MDM2 genes expressions,the prognosis of bladder cancer can be decided. 　　Key words：Bladder neoplasm；P53 gene；MDM2 gene；Immunohistochemistry；Apoptosis MDM2基因是一原癌基因，与P53构成降解反式激活循环通路，参与细胞生长抑制、凋亡、细胞周期调控等过程。细胞凋亡是由基因调控的细胞主动死亡过程，同肿瘤的发生发展以及临床治疗有密切的关系。本研究采用免疫组化方法观测MDM2、P