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目的 通过研究肝胆管结石合并肝胆管癌和肝胆管结石症组织中 cyclin D1 和 p2 7kipl及 ki- 6 7表达 ,探讨肝胆管结石与合并肝胆管癌之间的关系 ,以及临床应用价值。 方法 以 32例肝胆管结石合并肝胆管癌患者为研究对象 ,49例肝胆管结石症作为对照 ,将各例手术切除标本的石蜡组织块重新作 4μm切片 ,应用免疫组织化学 SP法检测 cyclin D1 、p2 7kipl和 ki- 6 7表达。 结果 (1)在正常胆管组织、肝胆管结石胆管上皮呈单纯增生、不典型增生 ,肝胆管结石合并肝胆管癌及癌旁组织各组中 ki- 6 7抗原平均指数、cyclin D1 阳性分级表达均呈现正常 <单纯增生 <不典型增生 <癌 ,而p2 7kipl阳性表达分级呈现正常 >单纯增生 >不典型增生 >癌 ,经统计学分析均有显著意义 (P<0 .0 0 1)。 (2 )结石合并肝胆管癌组织中 ki- 6 7抗原、cyclin D1 表达与肝胆管癌分化程度呈正相关 (P<0 .0 1) ,而 p2 7kipl阳性表达与肝胆管癌分化程度无明显关系。 (3)高分化肝胆管癌与肝胆管结石症胆管组织不典型增生两组间 cyclin D1 和 p2 7kipl的表达差异无显著性 (P>0 .0 5 ) ,而 ki- 6 7表达差异有显著性 (P<0 .0 1)。(4 )结石合并肝胆管癌与肝胆管结石症组织中 ,cyclin D1 阳性分级表达与 ki- 6 7抗原表达呈正相关 ,Kandell相关?
Objective To investigate the expression of cyclin D1, p27kipl and ki-67 in hepatolithiasis and cholangiocarcinoma and hepatolithiasis, and to explore the relationship between hepatolithiasis and cholangiocarcinoma and its clinical value. Methods Thirty-two patients with hepatolithiasis were included in this study. Forty-nine patients with hepatolithiasis were selected as controls. The paraffin sections of the resected specimens were re-made into 4μm sections. The expressions of cyclin D1, p2 7kipl and ki- 6 7 expression. Results (1) The average index of Ki-67 antigen and the positive expression of cyclin D1 in normal bile duct tissues and hepatolithiasis bile duct epithelium were hyperplasia, atypical hyperplasia, hepatolithiasis and hepatocellular carcinoma tissues However, the positive expression of p27kipl showed normal> simple hyperplasia> atypical hyperplasia> cancerous, which was statistically significant (P <0.001). (2) There was a positive correlation between the expression of Ki-67 antigen and cyclin D1 in hepatocellular carcinoma (P <0.01), while the positive expression of p27ipi1 was not related to the differentiation of hepatocellular carcinoma . (3) There was no significant difference in the expression of cyclin D1 and p27kipl between the two groups (P> 0.05), while there was a significant difference in the expression of Ki-67 between the two groups Sex (P <0. 01). (4) There was a positive correlation between the positive expression of cyclin D1 and the expression of Ki-67 in stones with hepatocellular carcinoma and hepatolithiasis.