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目的 研究p53、bcl2及PCNA在大肠癌发生发展中的意义。方法 应用聚合酶链反应—单链构象多态性分析检测40例腺瘤和80例腺癌中p53基因第5～8外显子突变,同时应用免疫组化SP法分别检测大肠正常粘膜、增生性息肉、腺瘤以及腺癌中p53、bcl2、PCNA的蛋白表达。结果 175%(7/40)腺瘤和4625%(37/80)腺癌可见p53基因突变;腺瘤、腺瘤癌变及腺癌中p53蛋白表达率分别为225%,706%和588%;正常粘膜和增生性息肉中未见p53表达,p53蛋白表达与其基因突变相关(rs=054),但与临床病理因素及预后无关(P>005);bcl2在所有正常粘膜和增生性息肉基底部上皮细胞、779%腺瘤、647%的腺瘤癌变和55%腺癌可见表达,在腺瘤和腺癌中bcl2表达差异有显著性(P<005),高分化腺癌bcl2表达率明显高于差分腺癌(P<001)。应用Spearman相关分析,bcl2与p53表达在腺瘤及腺癌组织中呈负相关。PCNA强表达率在大肠腺瘤—癌序列中逐渐增高,它与腺瘤p53表达和不典型增生程度、腺癌组织分化和淋巴结转移相关(P<005),但与p53、bcl2表达及其它因素无关。结论 p53基因改变主要涉及到良性腺癌的转变过程,p53基因突变是参与和影响p53蛋白表达和生物学功能的主要因素。bcl2表达是大肠癌发生中的早期事件,在大多数肠癌中是抑制细胞凋亡。大肠癌发生与腺瘤或腺癌中
Objective To study the significance of p53, bcl2 and PCNA in the development of colorectal cancer. Methods Polymerase chain reaction-single strand conformation polymorphism analysis was used to detect mutations in exon 5-8 of p53 gene in 40 adenomas and 80 adenocarcinomas. Simultaneously, immunohistochemical SP method was used to detect normal mucosa and hyperplasia. Expression of p53, bcl2, and PCNA in polyps, adenomas, and adenocarcinomas. Results The p53 gene mutation was found in 175% (7/40) adenomas and 4625% (37/80) adenocarcinomas. The expression rates of p53 protein in adenomas, adenomas, and adenocarcinomas were 225%, 706%, and 588%, respectively. No expression of p53 was detected in normal mucosa and hyperplastic polyps. The expression of p53 protein was associated with its gene mutation (rs=054), but was not associated with clinical pathological factors and prognosis (P>005). bcl2 was found in all normal mucosa and hyperplastic polyp basement. Epithelial cells, 779% adenomas, 64% of adenomas, and 55% of adenocarcinomas were observed. The expression of bcl2 in adenomas and adenocarcinomas was significantly different (P < 005). The expression of bcl2 was significantly higher in well-differentiated adenocarcinomas. For differential adenocarcinoma (P < 001). Using Spearman correlation analysis, bcl2 and p53 expression were negatively correlated in adenoma and adenocarcinoma tissues. The strong expression rate of PCNA was gradually increased in colorectal adenoma-carcinoma sequence. It was associated with p53 expression and atypical hyperplasia, adenocarcinoma tissue differentiation and lymph node metastasis (P < 005), but it was correlated with p53, bcl2 expression and other factors. Nothing to do. Conclusion The p53 gene alterations mainly involve the transition process of benign adenocarcinomas. p53 gene mutations are the main factors involved in and affect the expression and biological functions of p53 protein. Bcl2 expression is an early event in the development of colorectal cancer, and it is a suppressor of apoptosis in most colorectal cancers. Colorectal Carcinogenesis and Adenoma or Adenocarcinoma