P16、Rb和PCNA在非小细胞肺癌的表达及临床意义  

Alterations of expression of P16,Rb and PCNA in Non-small cell lung cancer and their clinical significance

作　　者：李相国[1] 齐景宪[2] 易明福 

机构地区：[1]温州医学院附属温岭医院呼吸内科,317500 [2]郑州大学第二临床医学院 [3]河南省信阳市中心医院

出　　处：《临床肺科杂志》2008年第8期1002-1004,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的检测P16、Rb和PCNA在非小细胞肺癌中表达的改变，并探讨其临床意义。方法收集88例NSCLC手术切除标本存档蜡块，其中鳞癌63例，腺癌25例；Ⅰ～Ⅱ期48例，Ⅲ～Ⅳ期40例。取正常肺组织20例作对照。应用免疫组织化学SABC法检测全部标本中P16、Rb、PCNA的表达情况，并计数PCNA增殖指数（PI）。结果P16蛋白表达缺失率为51．1％（45／88），Rh表达缺失率为21．6％（19／88），P16与Rb表达呈负相关；Rb表达缺失表现为较高的细胞增殖活性，Rb（＋）与Rb（-）组PCNA增殖指数分别为30．8±17．1，58．1±19．2，组间差异有显著性（P〈0．01），P16（＋）与P16（-）组间PCNA增殖指数分别为39．5±18．7，34．0±22．5，差异无显著性（P〉0．05）。结论p16基因改变在NSCLC发生中起重要作用，是NSCLC早期诊断的有用指标。Rh基因改变不是NSCLC发生发展的重要机制，P16与Rb表达呈负相关，P16和Rh作用于细胞周期和肿瘤抑制的单一途径，存在负反馈回路。Rb表达缺失表现为较高的细胞增殖活性，可能在预后估计上有一定意义。Objective Detecting the alteration of P16, Rb and PCNA in non-small cell lung cancer （ NSCLC）, explore their relationship with the tumor cell proliferation and the correlation with carcinogenesis, development and behavior in NSCLC. Materials and Methods 88 NSCLC reseeted specimens were collected from the first and second clinical medical college, Zhengzhou University, 60 males and 28 females, 63 squamous cell carcinoma and 25 adenoearcinoma, 48 were in stage Ⅰ - Ⅱ, 40 were in stage Ⅲ- Ⅳ. 20 normal lung tissue specimens were collected as a control group. Immunohistochemical SABC techniques were used to detect the expression of P16, Rb and PCNA. PCNA immunstain - positive cells were enumerated as proliferative index. Results P16 expression loss rate was 51.1% （45/88）. There was no significant difference according to histological types （ squamous cell carcinoma or ad ） , differentiation （well or moderate, poor）, lymph node metastasis （positive or negative） and stage（ Ⅰ -Ⅱ or Ⅲ-Ⅳ） （P 〉0.05）. Rb expression loss rate was 21.6% （19/88）, and there was no significant differece according to histological types, differentiation, lymph node metastasis and stages （P 〉 0. 05 ）. There was inverse correlation between expression of Rb and P16. PCNA proliferative index showed significant difference according to Rb status, PI 30. 8 ± 17. 1,58. 1 ± 19. 2 for Rb（ ＋ ）, Rb（ - ） respectively （P 〈0. 01 ）. Conclusion p16 gene alteration plays an important role in NSCLC and may be an early event. Rb alteration is not the important mechanism in NSCLC. P16 and Rb alterations can be one kind of methods to distinguish NSCLC and SCLC. There was an inverse correlation between expression of Rb and P16, P16 and Rb are involved in a single pathway of cell cycle and tumor suppression, forming a negative feedback hoop. Rb expression loss showed higher proliferative activity, and might predict poor survival in NSCLC.

关 键 词：非小细胞肺癌 细胞增殖活性 P16 RB PCNA 小细胞肺癌 免疫组织化学 

分 类 号：R734.2[医药卫生—肿瘤]