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目的 探讨 p16、p5 3蛋白表达与胃癌细胞增殖、浸润、转移及预后的关系。方法 应用免疫组化S -P法研究 10 0例胃癌 ,2 0例中、重度异型增生 ,16例萎缩性胃炎和 10例正常胃黏膜p16、p5 3蛋白和增殖细胞核抗原 (PC NA)的表达。结果 正常胃黏膜 p16阳性率为 80 % ,p5 3未表达。萎缩性胃炎、异型增生和胃癌组织中 p16阳性率分别为 68 8%、3 5 %和 4 3 % ;p5 3阳性率分别为 12 5 %、2 5 %和 5 6%。p16在胃癌中的阳性率与预后明显相关 (P<0 .0 5 ) ;p5 3阳性率与肿瘤病理分级、Lanren分型有显著相关 (P <0 .0 5 ) ,与预后关系密切 (P <0 .0 1)。从正常胃黏膜到病变组织PCNA指数逐渐上升 ,以异型增生、胃癌细胞增殖显著 (P <0 .0 1) ,癌细胞PCNA指数p16阴性组 ,p5 3阳性组高于对照组 ,与肿瘤大小、浸润深度密切相关 (P <0 .0 5 )。p16、p5 3阳性表达具有协同性 (P <0 .0 5 )。结论 胃黏膜中、重度异型增生有较高的增殖活性 ,基因水平上已表现出癌变特性 ,是癌变发生过程中的一个重要阶段。p16、p5 3蛋白表达在胃癌的发生发展中起重要作用 ,可作为判断预后的可靠指标。
Objective To investigate the relationship between the expression of p16 and p5 proteins and the proliferation, invasion, metastasis and prognosis of gastric cancer cells. Methods The expression of p16, p5 3 proteins and proliferating cell nuclear antigen (PCNA) in 10 0 cases of gastric cancer, 20 cases of moderate and severe dysplasia, 16 cases of atrophic gastritis and 10 cases of normal gastric mucosa were studied by immunohistochemical S-P method. . Results The positive rate of p16 in normal gastric mucosa was 80%, while p5 3 was not expressed. The positive rates of p16 in atrophic gastritis, dysplasia and gastric cancer tissues were 68.8%, 35% and 43%, respectively. The positive rate of p53 was 125%, 25% and 56% respectively. The positive rate of p16 in gastric cancer was significantly correlated with prognosis (P <0.05). The positive rate of p5 3 was significantly correlated with tumor grade and Lanren classification (P <0.05), which was closely related to prognosis <0 .0 1). PCNA index gradually increased from normal gastric mucosa to diseased tissue, with dysplasia, significant proliferation of gastric cancer cells (P <0.01), PCNA index p16 negative cells and p5 3 positive cells of cancer cells were higher than those of control group, Invasion depth is closely related (P <0. 05). p16, p5 3 positive expression with synergy (P <0.05). Conclusions In gastric mucosa, severe dysplasia has higher proliferative activity, which has shown carcinogenicity at the gene level, which is an important stage in carcinogenesis. p16, p5 3 protein expression plays an important role in the occurrence and development of gastric cancer, can be used as a reliable indicator of prognosis.