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目的 研究胆管癌组织中 p5 3基因表达、ki- 6 7增殖指数高低及它们之间的关系 ,以深入探讨胆管癌发生、发展的机制。方法 采用原位杂交及免疫组化方法对 30例人胆管癌组织 p5 3基因、P5 3蛋白表达及 ki- 6 7蛋白增殖指数进行检测 ,探讨它们之间的关系 ,并进而分析它们与临床病理资料之间的相关性。结果 原位杂交检测30例胆管癌组织中 14例 (46 .7% ) p5 3基因表达阳性 ,p5 3原位杂交结果与胆管癌的临床病理资料无显著相关性。免疫组化检测 30例胆管癌组织中 16例 (5 3.3% )有 P5 3蛋白表达 ,有局部淋巴结转移组 P5 3蛋白表达阳性率明显高于无局部淋巴结转移组 ;临床 期患者 P5 3蛋白表达阳性率明显高于临床 、 期患者。有 P5 3蛋白表达的患者生存期明显短于无 P5 3蛋白表达的患者。 2 9例 (96 .7% )胆管癌患者的肿瘤细胞中有 ki- 6 7蛋白表达。在中、低分化、有局部淋巴结转移、临床 期肿瘤组织中 ,ki- 6 7增殖指数显著高于高分化、无局部淋巴结转移及临床 、 期患者。生存期长的肿瘤患者 ,ki- 6 7增殖指数低于生存期短的患者。结论 ki- 6 7增殖指数反映了胆管癌细胞的增殖活性 ,分化程度低的肿瘤细胞增殖活跃 ,局部淋巴结转移的危险性较大 ,临床预后较差 ,提示 ki- 6 7增殖指数是用来判断胆管
Objective To study the expression of p53 gene and the proliferation index of ki-67 in cholangiocarcinoma and the relationship between them, in order to further investigate the mechanism of the occurrence and development of cholangiocarcinoma. Methods In situ hybridization and immunohistochemistry were used to detect the expression of p53 gene and P53 protein in 30 cases of human cholangiocarcinoma and the proliferation index of ki-67 protein. The relationship between them and their relationship with clinical pathology were analyzed. The correlation between data. Results In situ hybridization detected the expression of p53 gene in 14 cases (46.7%) of cholangiocarcinoma in 30 cases. The in situ hybridization of p53 has no significant correlation with the clinicopathological data of cholangiocarcinoma. The expression of P53 protein was detected in 16 cases (53.3%) of 30 cases of cholangiocarcinoma by immunohistochemistry. The positive rate of P53 protein expression in the group with regional lymph node metastasis was significantly higher than that in group without regional lymph node metastasis; the expression of P53 protein in clinical stage was detected. The positive rate was significantly higher than that of clinical and stage patients. The survival of patients with P53 protein expression was significantly shorter than those without P53 protein expression. Twenty nine (96.7%) patients with cholangiocarcinoma had ki-67 protein expression in tumor cells. In the moderately and poorly differentiated, with regional lymph node metastases, and in clinical tumor tissues, the proliferation index of ki-67 was significantly higher than that of patients with well-differentiated, non-local lymph node metastasis and clinical stage. In patients with long-lived tumors, the ki-67 proliferation index was lower than those with short survival time. Conclusion The ki-67 proliferation index reflects the proliferation activity of cholangiocarcinoma cells. The proliferation of tumor cells with low differentiation degree is active. The risk of regional lymph node metastasis is larger and the clinical prognosis is poor. It is suggested that the Ki-67 proliferation index is used to judge bile duct