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70例不同胆囊病变标本包括胆囊腺癌30例］、胆结石20例、慢性胆囊炎20例，应用免疫组化观察P53蛋白、癌胚抗原（CEA）、增殖细胞核抗原（PCNA）表达状态及病变组织内S－100蛋白阳性树突状细胞（S-100+DC）浸润情况。p53蛋白、CEA及PCNA表达的阳性检出率，胆囊癌组分别为46．7％（14／30）、30％（9／30）及86．7％（26／30）；胆囊结石组分别为0、15％（3／20）及35％（7／20）；胆囊炎组分别为0、0及25％（5／20）。癌与非癌病变之间有明显差异（P＜0．05）。S-100+DC浸润阳性检出率，癌组织为40％（12／30）、胆囊结石组织为50％（10／20）、胆囊炎为85％（17／20）。S－100+DC的阳性检出率与组织内浸润细胞的密度，胆囊炎组与癌、胆囊结石组之间均存在明显统计学差异（P＜0．05）。研究结果提示：1）胆囊炎组织无肿瘤相关分子表达，但存在较高的免疫活性；2）胆结石标本内存在某些上皮细胞恶性转化，且其免疫活性有所降低。这种病变可能有较高肿瘤发生的危险；3）胆囊癌组织不仅有突变型P53基因、CEA及PCNA的过度表达，同时伴有免疫能力的损害，丧失了对肿瘤细胞的免疫监视作用，从而有利于癌的发展。
Seventy patients with different gallbladder lesions included 30 cases of gallbladder adenocarcinoma, 20 cases of gallstones and 20 cases of chronic cholecystitis. The expression of P53 protein, carcinoembryonic antigen (CEA), proliferating cell nuclear antigen (PCNA) and pathological changes were observed by immunohistochemistry. Infiltration of S-100 protein-positive dendritic cells (S-100+DC) in the tissue. The positive detection rates of p53 protein, CEA, and PCNA expression were 46.7% (14/30), 30% (9/30), and 86.7% (26/30) respectively in gallbladder cancer group; It was 0, 15% (3/20) and 35% (7/20); the cholecystitis group was 0, 0, and 25% (5/20). There was a significant difference between cancerous and non-cancerous lesions (P<0.05). The positive rate of S-100+DC infiltration was 40% (12/30) in cancer tissue, 50% (10/20) in gallstone tissue, and 85% (17/20) in cholecystitis. The positive detection rate of S-100+DC and the density of infiltrating cells in the tissue were significantly different between the cholecystitis group and the cancer and gallstone group (P<0.05). The results suggest that: 1) There is no expression of tumor-associated molecules in cholecystitis tissues, but there is a high level of immune activity; 2) Gallstones have malignant transformation in certain epithelial cells, and their immune activity is reduced. This lesion may have a higher risk of tumor formation; 3) Gallbladder cancer tissue not only has overexpressed mutant P53 gene, CEA, and PCNA, but also has immunological damage and loss of immune surveillance on tumor cells. It is good for the development of cancer.