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目的 :探讨癌基因及抑癌基因改变与膀胱癌生物学行为的关系。方法 :采用免疫组织化学方法及分子生物学技术 ,检测了82例膀胱移行细胞癌P21、P185、P53蛋白表达及38例P53基因突变。结果 :P21、P185、P53蛋白表达阳性率分别为62.2 %(51例)、58.5 %(48例)、31.7 %(26例)。12例(31.6 %)有P53抑癌基因突变 ,其中全部有第280位密码子G C突变 ;3例合并有248密码子突变 ;1例有249密码子点突变。结论 :P21、P53蛋白表达阳性率与膀胱移行细胞癌病理分级及临床分期呈正相关(P<0.01) ;P185蛋白阳性率与分级、分期呈负相关(P<0.05)。P53抑癌基因点突变与病理分级和临床分期呈显著正相关(P<0.05) ;与预后显著相关(P<0.05) ;且死亡率高于点突变阴性者。
Objective: To investigate the relationship between oncogene and tumor suppressor gene and the biological behavior of bladder cancer. Methods: Immunohistochemistry and molecular biological techniques were used to detect the expression of P21, P185 and P53 in 82 cases of bladder transitional cell carcinoma and 38 cases of P53 gene mutation. Results: The positive rates of P21, P185 and P53 were 62.2% (51 cases), 58.5% (48 cases) and 31.7% (26 cases) respectively. Twelve cases (31.6%) had P53 tumor suppressor gene mutations, all of which had G C mutation at codon 280; three had 248 codon mutations; and one had a 249 codon point mutation. Conclusion: The positive rate of P21 and P53 protein expression is positively correlated with the pathological grading and clinical stage of bladder transitional cell carcinoma (P <0.01). The positive rate of P185 protein is negatively correlated with grading and staging (P <0.05). The point mutation of P53 was positively correlated with pathological grade and clinical stage (P <0.05), but significantly correlated with prognosis (P <0.05), and the mortality rate was higher than that of point mutation negative.