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目的:观察大肠腺癌,腺瘤恶变区及非恶变区细胞凋亡及其调控基因p53的表达状态,探讨它们在大肠上皮恶性转化进程中的作用及二者的关系。方法:利用DNA缺口末端标记技术,p53蛋白免疫组化染色及双重染色技术,原位观察27例大肠腺癌及21例腺瘤恶变标本中凋亡细胞和p53阳性表达细胞的密度与分布,以8例非肿瘤大肠粘膜作为对照。结果:腺瘤非恶变区凋亡细胞密度分别高于腺癌(P<0.01)、腺瘤恶变区(P<0.01)及非肿瘤粘膜(P<0.01)。腺癌及腺瘤恶变区p53蛋白阳性细胞密度均高于腺瘤非恶变区(P<0.01)及非肿瘤粘膜(P<0.01)。双染原位观察p53蛋白与凋亡细胞的分布发现:p53阳性区凋亡细胞有明显减少趋势,而p53阴性区凋亡细胞分布则有增加趋势。结论:p53蛋白突变在大肠癌发展中具重要的促恶变形成作用,其作用可能是通过抑制细胞凋亡而实现的。
OBJECTIVE: To observe the apoptosis of adenocarcinoma, adenoma malignant and non-malignant adenocarcinoma and the expression of its regulatory gene p53 in colorectal adenocarcinoma, and to explore their roles in the process of malignant transformation of colorectal epithelium and their relationship. Methods: The density and distribution of apoptotic cells and p53 positive cells in 27 cases of colorectal adenocarcinoma and 21 cases of adenoma malignant transformation were observed by DNA nick end labeling, p53 protein immunohistochemistry and double staining. Eight non-tumor colorectal mucosa served as controls. Results: The density of apoptotic cells in non-malignant adenoma was higher than that in adenocarcinoma (P <0.01), adenoma (P <0.01) and non-tumor mucosa (P <0.01). The positive cell density of p53 protein in adenocarcinoma and adenoma was higher than that in non-malignant adenoma (P <0.01) and non-tumor mucosa (P <0.01). Double staining in situ observation of the distribution of p53 protein and apoptotic cells found that: apoptotic cells in p53-positive cells decreased significantly, while the distribution of apoptotic cells in p53-negative cells increased. Conclusion: The mutation of p53 protein may play an important role in promoting the malignant transformation in the development of colorectal cancer. Its function may be through the inhibition of apoptosis.