大肠腺瘤-腺瘤恶变-腺癌演进过程中PCNA、p53与细胞凋亡的表达及其关系  

The expression of apoptosis, PCNA and p53 in colorectal adenoma, malignantly transformed adenoma and adenocarcinoma

作　　者：刘易欣[1] 赵秀兰[1] 王展宏[1] 方桢[2] 孙保存[3] 

机构地区：[1]天津医科大学院病理教研室,300070 [2]天津中医学院第一附属医院消化科 [3]天津医科大学肿瘤医院病理科

出　　处：《天津医科大学学报》2001年第3期310-313,共4页Journal of Tianjin Medical University

基　　金：天津市自然科学基金项目资助 (编号:973611311)

摘　　要：目的 :观察大肠腺瘤 -腺瘤恶变 -腺癌演进过程中细胞凋亡与p53、PCNA的表达状况 ,探讨其内在联系。方法 :利用DNA缺口末端标记技术 ,PCNA、p53蛋白免疫组织化学染色及p53与凋亡双重染色技术 ,原位观察大肠腺癌、腺瘤恶变区、腺瘤非恶变区及管状绒毛状腺瘤 (分别为34、27、27及27例 )标本中凋亡细胞和PCNA、p53阳性表达细胞密度及分布 ,以非肿瘤大肠粘膜 (6例 )作为对照。结果 :腺瘤非恶变区凋亡细胞密度分别高于腺癌、管状绒毛状腺瘤及非肿瘤粘膜 (P均<0.01)。腺癌及腺瘤恶变区p53蛋白阳性细胞密度分别高于管状绒毛状腺瘤 (P均<0.01)和腺瘤非恶变区 (P均<0.01)及非肿瘤粘膜 (P分别<0.01)。腺癌PCNA阳性细胞密度分别高于腺瘤恶变区 (P<0.05)、管状绒毛状腺瘤 (P<0.01)、腺瘤非恶变区 (P<0.01)及非肿瘤粘膜 (P<0.01) ,而腺瘤恶变区亦分别高于后3组 (P分别<0.01)。双染原位观察p53蛋白与凋亡细胞的分布发现 :p53低表达区凋亡细胞分布则有增加趋势。结论 :p53突变可能通过抑制细胞凋亡促进大肠癌的形成 ,而当突变型p53蛋白表达增加时 ,PCNA表达亦增加 ,提示p53突变的肿瘤具有较高的增殖活性 ,其中腺癌增殖程度最高。Objective: To investigate the relations between p53 and apoptosis and proliferation in different stages of malignant transformation of large intestine epithelia. Methods: The density and distribution of the apoptotic cells and positive expressions of p53 protein (in situ) and PCNA were observed in 27 cases of tubular and villous adenomas, 27 cases of malignantly transformed adenomas and 34 cases of adenocarcinomas of the large intestine, using DNA end labeling technique for apoptotic cells, immunohistochemical staining for PCNA and p53 proteins, and double staining technique for both p53 and apoptosis.6 cases of nontumor mucosas were used as controls. Results: The densities of apoptotic cells in benign areas of malignantly changed adenomas was significantly higher than those in adenocarcinomas (P<0.01) malignant areas of adenomas (P<0.01) tubular and villous adenomas (P<0.01) and nontumor mucosas (P<0.01), respectively. The densities of p53 protein positive cells in malignant areas of adenomas and adenocarcinomas were significantly higher than those in malignant areas of adenomas (P<0.05), tubular and villous adenomas (P<0.01) and nonturnor mucosas (P<0.01), while the densities of PCNA cells in malignant areas of adenomas were significantly higher than the later 3 groups(P<0.01 respectively), The distributions of p53 protein and apoptosis cells observed through double staining showed a tendency to decrease of apoptosis in p53 protein positive areas, while showing a tendency to increase in p53 negative areas. Conclusion: p53 mutations play a critical part in the formation and progression of carcinoma of large intestine, probably through decreasing in apoptosis. Meanwhile, with the increasing expression of mutant p53 protein, PCNA expression is in creased, indicating that tumor with p53 mutation is higher proliferative activity and the adenocarcinoma is the highest in all tumors.

关 键 词：大肠肿瘤 P53 PCNA 细胞凋亡 增殖 病理 

分 类 号：R735.340.2[医药卫生—肿瘤]