p16^(INK4a)和Ki67在胃癌及癌前病变中的表达和意义  

Expression and significance of p16^(INK4a) and Ki67 in the gastric cancer and precancerous lesions

作　　者：李照强 黄小钟[1] 李宗芳 杨军[1,3] Li Zhaoqiang;Huang Xiaozhong;Li Zongfang;Yang Jun(Department of Pathology,The Second Affiliated Hospital of Xi＇an Jiaotong University,Shaanxi Xi＇an 710004,Chian;ZDepartment of Pa thology,The People＇s Hospital of Tongchuan city,Shaanxi Tongchuan 727000,China;National-local Joint Engineering Research Cen ter of Biological diagnosis and Biotherapy,Shaanxi Xi＇an 710004,China)

机构地区：[1]西安交通大学第二附属医院病理科,陕西西安710004 [2]铜川市人民医院病理科,陕西铜川727000 [3]生物与诊断治疗国家地方联合工程研究中心,陕西西安710004

出　　处：《现代肿瘤医学》2018年第14期2223-2227,共5页Journal of Modern Oncology

基　　金：国家自然科学基金(编号:30872403);教育部新世纪优秀人才计划(编号:NCET-10-0647);教育部"长江学者和创新团队发展计划"创新团队(编号:IRT1171)

摘　　要：目的:探讨p16^(INK4a)、Ki67在慢性胃炎、胃上皮内瘤变、胃癌及癌旁非肿瘤性胃黏膜中的表达和临床意义。方法:采用免疫组织化学SP法检测23例慢性胃炎、16例胃低级别上皮内瘤变、16例胃高级别上皮内瘤变、45例胃癌及癌旁非肿瘤性胃黏膜组织样本中p16^(INK4a)、Ki67的表达。结果:p16^(INK4a)在慢性胃炎、低级别上皮内瘤变、高级别上皮内瘤变和胃癌细胞中均呈核浆型表达,阳性表达率分别为4.34%、25.00%、62.50%、66.67%,在癌旁非肿瘤性胃黏膜腺体上皮细胞中呈阴性表达;Ki67在慢性胃炎、低级别上皮内瘤变、高级别上皮内瘤变和胃癌组织细胞中呈核型表达,Ki67指数分别为17.39%、37.50%、56.25%和77.78%。结论:p16^(INK4a)代偿性高表达是胃癌和胃癌前病变的重要免疫表型特征,联合检测p16^(INK4a)和Ki67表达可作为胃癌诊断的分子靶标和可靠方法。Objective： To investigate the expression and clinical significance of p16^（INK4a） and Ki67 in chronic gastritis,gastric intraepithelial neoplasia,gastric cancer and non-tumorous gastric mucosa. Methods： p16^（INK4a） and Ki67 proteins were detected with immunohistochemical SP method in 23 chronic gastric,32 gastric intraepithelial neoplasia,45 gastric cancer. Results： p16^（INK4a） was found in nuclei and plasma in chronic gastritis,gastric intraepithelial neoplasia,gastric cancer and non-tumorous gastric mucosa. The positive expression rates were 4. 34%,25. 00%,62. 5%,66. 67% respectively. In the paracancerous non-neoplastic gastric mucosa,p16^（INK4a） is weakly expressed only. The positive expression rates of Ki67 in chronic gastritis,low grade intraepithelial neoplasia,high grade intraepithelial neoplasia,and gastric cancer were gradually increased by 17. 39%,37. 50%,56. 25% and 77. 78% respectively. In the non-neoplastic gastric mucosa,no Ki67 expression was observed. Conclusion： p16^（INK4a） was upregulated in the gastric precancerous and part of gastric cancer,and some cases of gastric cancer were all negative expression. This process represented a different mechanism of abnormal cell cycle regulation during carcinogenesis. The positive expression rate of Ki67 was increased in gastric intraepithelial neoplasia and gastric cancer significantly. The combination of the two proteins not only provides an important method for the diagnosis of gastric cancer and precancerous lesions,but also provides valuable information for the study of gastric cancer mechanism.

关 键 词：胃癌 上皮内瘤变 细胞周期 P16INK4A KI67 

分 类 号：R735.2[医药卫生—肿瘤]