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目的 检测抑癌基因P16,P21和P53在骨巨细胞瘤(GCT)组织中的表达,探讨它们之间的相关性及与病理分级的关系,以进一步了解GCT的发生,细胞学性质及生物学行为,为临床治疗提供参考。方法 用免疫组织化学方法对49例存档GCT蜡块标本进行了检测。结果(1)P16、P21和P53 3种抑癌基因产物在GCT中均有表达,单核基质细胞和多核巨细胞均可着色,阳性率分别为71.4％、85.7％、38.8％,阳性细胞呈散在,片状或团块状分布。(2)P53在Ⅲ级与Ⅰ级和Ⅱ级之间的表达差异有显著性(P<0.01),P21在Ⅲ级与Ⅰ级之间的表达差异有显著性(P<0.01)。(3)P16和P21在GCT中的表达具有高度相关性(x~2=7.2,P<0.01),P16与P53,P21和P53之间的表达无相关性(x~2分别为2.728和3.593,P>0.05)。结论(1)GCT中存在两种单核基质细胞和多核巨细胞,部分单核基质细胞和少数多核巨细胞为肿瘤细胞,单核基质细胞为P53表达的主要肿瘤细胞成分。(2)病理分级能在一定程度上反映GCT的良恶性,结合P53与P21的检测可作为判断预后的指标。(3)P16蛋白与P21蛋白的表达呈高度相关性,P16蛋白与P53蛋白,P21蛋白与P53蛋白的表达没有相关性。
Objective To detect the expression of tumor suppressor genes P16, P21 and P53 in giant cell tumor of bone (GCT) and to explore the correlation between them and their relationship with pathological grade so as to further understand the occurrence, cytology and biology of GCT Behavior, provide a reference for clinical treatment. Methods 49 cases of archived GCT wax specimens were detected by immunohistochemistry. Results (1) The products of three tumor suppressor genes P16, P21 and P53 were expressed in GCT. The mononuclear stromal cells and multinucleated giant cells could be colored, the positive rates were 71.4%, 85.7% and 38.8%, respectively. The positive cells Scattered, flaky or lumpy distribution. (2) There was a significant difference in the expression of P53 between grade Ⅲ and grade Ⅰ and Ⅱ (P <0.01). There was a significant difference in the expression of P21 between grade Ⅲ and grade Ⅰ (P <0.01). (3) The expression of P16 and P21 in GCT was highly correlated (x ~ 2 = 7.2, P <0.01). There was no correlation between P16 and P53, P21 and P53 (x ~ 2 were 2.728 and 3.593 , P> 0.05). Conclusions (1) There are two types of mononuclear stromal cells and multinucleated giant cells in GCT. Some of the mononuclear stromal cells and the few multinucleated giant cells are tumor cells, and the mononuclear stromal cells are the main tumor cell components expressing P53. (2) The pathological grade can reflect the benign and malignant GCT to a certain extent. Combined with the detection of P53 and P21 can be used as an index to judge the prognosis. (3) The expression of P16 protein and P21 protein were highly correlated. P16 protein had no correlation with the expression of P53 protein, P21 protein and P53 protein.