bcl-2、ki-67和p53在喉鳞状细胞癌中的表达及临床意义

目的:探讨bcl-2、ki-67和p53在喉鳞状细胞癌中的表达及临床意义。方法:采用SP免疫组织化法检测60例喉鳞状细胞癌患者bcl-2、ki-67和p53的表达,并结合临床病理因素进行分析。结果:喉鳞状细胞癌中bcl-2、P53、Ki-67的阳性表达率分别为60.0%(36/60)、53.3%(32/60)、30.0%(18/60)。喉鳞状细胞癌患者的bcl-2、P53和Ki-67阳性表达与组织学分级及淋巴结转移密切相关,组织学分级越低,伴有淋巴结转移的喉鳞状细胞癌患者的bcl-2、P53和Ki-67阳性表达率明显高于其他组(P0.05),但与年龄、肿瘤大小并无显著相关性(P0.05)。结论:bcl-2、ki-67和p53是评价喉鳞状细胞癌预后的较好指标,三者联合检测有助于判断喉鳞状细胞癌的病理临床特征。     

IMP3蛋白在骨肉瘤组织中的表达与临床意义

目的:探讨IMP3蛋白在骨肉瘤组织中的表达及其临床意义.方法:选取骨肉瘤患者68例,以骨软骨瘤患者术后石蜡切片20例作为对照,应用SP免疫组化方法检测IMP3蛋白的表达,以分析其在骨肉瘤、骨软骨瘤组织中阳性表达的差异性及与预后的关系.结果:骨肉瘤组织中IMP3阴性、弱、中、强的表达依次为4.41%(3/68)、 22.06%(15/68)、 22.74%(19/68)、 45.59%(31/68),与骨软骨瘤组织相比,IMP3在骨肉瘤的表达存在显著上调( P <0.01).骨肉瘤中IMP3 表达与骨肉瘤患者术后3年存活率呈负相关( P < 0.01).结论:IMP3与骨肉瘤的发生、发展及预后有关,可作为新的骨肉瘤标记物,具有重要的临床意义.     

自噬基因Beclin1过表达骨肉瘤中Ki-67和P53的表达及相关性

目的探讨Beclin1过表达骨肉瘤组织中Ki-67、P53的表达及相关性。方法采用回顾性研究方法,选取我院诊治的骨肉瘤患者70例,所以患者均经免疫组化检测Beclin1的表达,根据Beclin1是否阳性表达进行分组比较,同时检测组织Ki-67、P53的表达,分析Beclin1过表达骨肉瘤中Ki-67、P53的表达差异性和相关性。结果在成骨性骨肉瘤、成纤维性骨肉瘤和成软骨性骨肉瘤3种骨肉瘤中Beclin1的表达差异无统计学意义(P0.05),总阳性率为62.86%,在Beclin1阳性组织中,P53的表达阳性率为52.27%,Ki-67表达阳性率为43.18%,与Beclin1阴性组比较差异具有统计学意义(P0.05);进一步相关分析显示,Beclin1的过表达与P53呈正相关(r=0.653,P=0.001),而与Ki-67呈负相关(r=-0.741,P=0.001)。结论自噬基因Beclin1过表达骨肉瘤组织中Ki-67、P53的表达状态存在差异性,Beclin1过表达状态可能与下调Ki-67而抑制细胞增殖和促进P53的表达上调而促进细胞凋亡有关,最后对肿瘤发挥抑制作用。     

肺癌组织中突变型p53与Cox-2蛋白的相关性

目的探讨突变型p53和Cox-2蛋白在肺癌组织中表达的相关性及其对预后的影响。方法应用免疫组化SP法检测116例肺癌患者组织中突变型p53和Cox-2蛋白表达水平，并用CD34标记血管来计数肿瘤组织的微血管密度。结果116例肺癌中，突变型p53蛋白阳性47例（40．52％），Cox-2蛋白阳性78例（67．24％）。Cox-2蛋白的表达与肿瘤TNM分期（P=0．014）及其中的淋巴结转移情况（P=0．006）密切相关，且阳性表达的肺癌组织中微血管密度明显高于阴性表达者（P=0．000），有统计学意义。COX模型多因素分析显示，淋巴结的转移（P=0．004）和Cox-2蛋白的阳性表达（P=0．000）是肺癌患者的预后不良因素。结论突变型p53与Cox-2蛋白的表达有关，Cox-2可作为判断肺癌患者预后不良的潜在指标。     

非霍奇金淋巴瘤中survivin、bcl-2、bax、p53表达及其与细胞增殖和凋亡的关系

目的研究非霍奇金淋巴瘤(non-Hndgkin’s lymphoma,NHL)中survivin、bcl-2、bax和p53指标表达的情况,比较它们在B-NHL和T-NHL中的差异,探讨它们在临床病理实践中的应用价值。方法应用免疫组化、原位凋亡检测及组织芯片技术对190例NHL进行检测。结果①survivin、bcl-2、bax、p53在75例B-NHL中表达的总阳性率分别为70·67%、57·33%、46·67%和36·00%,在115例T-NHL中表达的总阳性率分别为81·74%、44·35%、46·09%和40·00%,其中bcl-2表达在B-NHL和T-NHL之间差异有显著性(P=0·045);②随着B-NHL生物侵袭性的增强,survivin表达率和表达强度升高(P=0·001),bcl-2表达率和表达强度下降(P=0·018);③在低中度侵袭组中,随着NHL生物侵袭性的增强,突变型p53表达率升高;在高侵袭组中p53的表达率反而降低;④随着NHL生物侵袭性的增强,Ki-67表达升高(P=0·014和P=0·002)。结论①survivin是判断NHL恶性及侵袭性有意义的指标,联合检测survivin和bcl-2蛋白的表达情况对判断B-NHL的侵袭性可能有互补作用;②p53表达可用于评价低中度侵袭性NHL的生物学行为;③Ki-67蛋白表达强度是评估NHL肿瘤细胞增殖的良好指标,它对NHL侵袭性的分级具有较为重要的参考价值。     

p16、p53和Ki-67蛋白在宫颈上皮内瘤变中的表达及意义

目的 探讨p16、p53和Ki-67蛋白在宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)中的表达及临床意义.方法 采用免疫组化SP法检测正常子宫颈或炎性病变组织、CIN1～3中p16、p53和Ki-67蛋白的表达.结果 p16、p53和Ki-67蛋白在正常子宫颈或炎性病变中罕见表达,在CIN1～3组织中三者表达均较高,随CIN级别升高p16、p53和Ki-67表达增强,各组间表达差异有统计学意义(P<0.05).同时p16、p53和Ki-67三者阳性表达均可见分层现象,在CIN1中大部分阳性细胞位于子宫颈鳞状上皮的下1/3,在CIN2中多累及上皮下2/3,而CIN3则普遍超过上皮的下2/3或全层弥漫阳性,各组间差异具有统计学意义(P<0.05).结论 p16、p53和Ki-67蛋白表达均与子宫颈上皮内瘤变的病变进展密切相关,联合检测p16和Ki-67的抗原表达可作为CIN分级诊断的辅助方法,具有较好的应用价值.     

热休克蛋白在涎腺肿瘤中的表达

目的 研究热休克蛋白(HSPs)在涎腺良性、恶性肿瘤中的表达特征,探讨其对涎腺肿瘤发生发展的影响及意义。方法 用免疫组化（S-P）法和免疫荧光双标记激光扫描共聚焦显微镜法检测41例良性和17例恶性肿瘤中HSPs的表达。采用stata7.0卡方检验和spearman相关分析。结果(1)5种HSPs在良、恶性肿瘤中均明显表达,且良性混合瘤的HSP84（β）和HSP86（α）的表达率均显著高于腺瘤和腺淋巴瘤（p均＜0.01）。(2)HSP27在恶性肿瘤中表达率显著下降,与肿瘤恶性显著负相关（r＝-0.3506, p＜0.01）,同时HSP70、HSP86（90α）在恶性肿瘤中的表达显著增加,尤其HSP70/HSP86（90α）在恶性肿瘤中双阳性表达率高达100%（Fisher's exact p＜0.05）。结论(1)HSPs共同参与了涎腺肿瘤的发生,但存在表达种类和率的差异。(2) HSP27表达减弱可能是涎腺肿瘤分化降低的标志。(3)HSP70、HSP90,尤其HSP86（90α）可能通过致瘤顾客蛋白的持续活化促使恶性肿瘤发生发展。以HSP86（90α）为主的Hsp90可能是涎腺恶性肿瘤治疗的靶点。     

骨软骨瘤继发肉瘤变临床病理分析

目的 分析骨软骨瘤继发肉瘤变的临床、影像学、组织病理学和免疫表型特征.方法 回顾上海交通大学附属第六人民医院1991-2008年间诊断的骨软骨瘤463例,其中单发性408例,多发性55例;重点分析11例骨软骨瘤继发肉瘤变病例的临床、影像学和组织学形态特点;采用免疫组织化学EnVision二步法检测7例骨软骨瘤肉瘤变组织及lO例未发生肉瘤变组织中CK、波形蛋白、S-100蛋白、p53及c-myc蛋白表达.结果 11例骨软骨瘤恶变病例其中5例为单发性(单发性恶变率1.2%),6例为多发性(多发性恶变率10.9%).男女比例为10:1.肉瘤变的部位分别是股骨4例,胫骨3例,肱骨1例,髂骨3例,耻骨1例,其中1例是髂骨和股骨联合病变.肉瘤变患者平均就诊年龄39.8岁,未肉瘤变骨软骨瘤平均就诊年龄20.4岁.肿瘤在骨表面结节状生长,体积巨大,边界不清,软骨帽厚度＞1.5 cm,有广泛钙化.恶变成分为周围型软骨肉瘤Ⅰ～Ⅱ级,肿瘤细胞侵及周围软组织,偶可累及髓腔.免疫组织化学标记结果显示肿瘤细胞表达波形蛋白和S-100蛋白.p53阳性表达见于其中2例肉瘤变的病例(2/7),未发生肉瘤变的病例未检测到p53阳性表达.结论 骨软骨瘤肉瘤变大多继发于多发性病例,发病年龄通常在30岁以后,有明显的男性发病优势,临床病史长,肿瘤体积巨大,软骨帽厚,钙化明显,结节状生长浸润周围软组织.恶变成分主要是周围型高分化软骨肉瘤,预后较好.p53基因突变可能是恶变的分子机制之一.     

p53,Ki-67及E-钙黏蛋白在三阴性乳腺癌中的表达及预后

目的:探讨p53,Ki-67及E-钙黏蛋白(E-cadherin)在三阴性乳腺癌(triple negative breast cancer,TNBC)组织中的表达及预后的关系.方法:采用免疫组织化学法检测52例TNBC和52例非三阴性乳腺癌(non-triple-negative breast cancer,NTNBC)组织中p53,Ki-67及E-cadherin表达情况,观察3个指标与TNBC患者临床病理学特征及预后的关系.结果:TNBC组织中p53,Ki-67及E-cadherin的阳性表达率分别为67.3％,80.8％,26.9％;而在NTNBC组织中为44.2％,61.5％,48.1％(均P＜0.05).在TNBC组织中,p53表达阳性与肿瘤大小、TNM分期及组织学分级有关(均P＜0.05);Ki-67表达阳性与TNM分期、淋巴结转移有关(均P＜0.05);E-cadherin表达阳性与肿瘤大小、TNM分期、淋巴结转移有关(均P＜0.05).在TNBC患者中,p53,Ki-67及E-cadherin表达阳性者与阴性者总体生存率(overall survival,OS)的差异均有统计学意义(P＜0.05).Cox回归分析多因素显示:淋巴结转移、p53、Ki-67及E-cadherin表达是影响TNBC患者总体生存率的独立预后因素(均P＜0.05).结论:TNBC组织中,p53、Ki-67高表达,其表达阳性者预后差,E-cadherin低表达,其表达阳性者预后良好.联合检测p53、Ki-67及E-cadherin表达可为TNBC患者的治疗提供新靶点.     

胃肠道间质瘤中p53、Ki-67、Bcl-2、CyclinD_1的表达及其与预后的关系

目的:分析32例胃肠道间质瘤(GISTs)病人组织切片中p53、Ki-67、Bcl-2和CyclinD1表达及其与预后的相关性。方法:采用免疫组化SABC法检测32例GISTs患者p53、Ki-67、Bcl-2和CyclinD1的表达。结果:p53在良性组均呈阴性,在交界组与恶性组呈阳性者为3例和15例;Ki-67指数在三组中表达分别为(8.97±4.12)%、(16.21±7.44)%和(22.33±9.14)%(P<0.01);Bcl-2在三组呈阳性者分别为2例、3例和12例;CyclinD1指数在三组中表达分别为16.95%、51.22%和69.38%。Ki-67表达大于20%有12例,存活时间平均10.5月,Ki-67表达小于20%的存活时间平均22.4月。结论:Ki-67增值指数不仅可用作评价GISTs恶性潜能的指标,而且Ki-67指数大于20%具有独立的预后意义。     

凋亡相关基因p53、bcl-2、bax在前列腺组织中的相关性

目的　探讨细胞凋亡相关基因p53、bcl-2、bax在前列腺组织中的相关性。 方法　收集36例前列腺癌(prostate caner, PCa)、20例前列腺增生(benign prostatic hyperplasia,BPH)和11例正常前列腺(normal prostatic, NP),应用免疫组织化学S-P法检测凋亡相关基因p53、bcl-2、bax蛋白的表达。 结果　①PCa和BPH组bcl-2蛋白阳性表达率明显高于NP组（P<0.05）,而PCa组与BPH组阳性率差异无显著性。PCa组p53蛋白阳性表达率明显高于BPH组和NP组（P<0.01）,而BPH组与NP组阳性率无显著性差异（P>0.05）。②p53与PCa分级有关,随着肿瘤分级增高而呈正相关（P<0.05）;bcl-2与PCa分级有关,随着肿瘤分级增高而呈正相关（P<0.01）,显示bcl-2、p53蛋白表达随着病理分级的增高而增高。PCa、BPH和NP中bax阳性表达率差异无显著性。③p53蛋白表达阳性率≤5年生存组明显高于>5年生存组,呈负相关（P<0.05）;bcl-2、bax蛋白表达与生存期无关（P>0.05）。 结论 细胞凋亡相关基因 p53、bcl-2、bax蛋白的异常表达与PCa的发生和发展、病理分级和预后有相关性。     

Protein expression of p53, p21 (WAF1/CIP1), bcl-2, Bax, cyclin D1 and pRb in human colon carcinomas

Tumour growth is regulated by a balance between proliferation, growth arrest and programmed cell death (apoptosis). Until recently, the majority of the studies dealing with oncogenesis has been focused on the regulation of cell proliferation. There is now growing understanding that control of growth arrest and apoptosis play key roles in the development of human cancer and in cancer treatment. Some of the more heavily studied proteins of importance for the control of growth arrest and apoptosis are p53, p21, bcl-2 and bax. Alterations in the p53 protein may lead to malignant transformation and defect therapy response, most likely as a result of defective p53-dependent apoptosis. In addition, p21 (WAF1/CIP1) is involved in cell-cycle arrest and probably in induction of p53-dependent apoptosis. Proteins belonging to the bcl-2 family are also important for normal apoptosis. Overexpression of bcl-2 protein is thought to reduce the apoptotic capacity, while bax protein seems to be necessary for induction of apoptosis. In this study, we have immunostained tissues from 93 primary colon carcinomas and have examined the expression of p53, p21 (WAF1/CIP1), bcl-2 bax, pRb and cyclin D1 for evaluation of their roles in colon-cancer progression. A highly significant association between p53 accumulation and downregulation of p21 (WAF1/CIP1) was seen. We also found a strong association between reduced/absent p21 and the development of metastases and death due to cancer disease. Cyclin D1, bcl-2 and bax protein failed to have independent prognostic impacts. Bcl-2 and bax protein levels showed an inverse relationship. The results of the present study indicate that reduced p21 protein levels play an important role in progression of colon cancer. We concluded that evaluation of p21 expression in primary colon carcinomas at the time of surgery might be a valuable tool in defining patients with a high risk of developing metastases. Received: 22 June 1999 / Accepted: 24 September 1999     

Survivin、Bcl-2和Bax蛋白在乳腺癌中的表达及其意义

目的：检测乳腺癌中 Survivin、Bc(?)-2和 Bax 蛋白的表达,探讨它们的相关性及临床意义。方法：用免疫组化和图像分析技术对乳腺癌中3种蛋白的表达进行定性、定位和定量研究。结果：(1)Survivin 在乳腺癌中表达, 并与临床分期有关；在正常乳腺组织中不表达,两者比较有显著性差异；(2)Bc(?)-2在乳腺癌中表达高于正常乳腺组织。Bc(?)-2与乳腺癌病理分级、临床分期有关；(3)Bax 在乳腺癌中表达低于正常乳腺组织。Bax 与乳腺癌病理分级、临床分期及腋淋巴结转移有关；(4)乳腺癌中 Survivin 的表达与 Bc(?)-2表达正相关,与 Bax 表达无关。结论：3种蛋白可通过抑制或促进细胞凋亡,对乳腺癌发生和发展起重要作用；在乳腺癌发展中 Survivin 与 Bc(?)-2 起协同作用。     

Relationship of Fas,FasL, p53 and bcl-2 expression in human non-small cell lung carcinomas

Objective: Lack of surface Fas expression is a main route for apoptotic resistance which is considered an important mechanism of tumorigenesis and tumor progression. Fas and FasL expression in 110 non-small cell lung carcinomas (NSCLCs) were investigated to evaluate their roles in pulmonary carcinogenesis and to examine the clinicopathologic significance of Fas expression with its relationship with p53 and bcl-2 over- expression. Methods: Immunohistochemical analysis using tissue microarray demonstrated that a large proportion of NSCLC patients (60%) showed lack of membranous Fas expression. The Fas-negative cases revealed the significantly lower survival rate than Fas-positive ones. Also, the loss of Fas receptor expression was found more frequently in advanced stage and higher nodal status. FasL protein was increased in most NSCLCs (89%) compared to normal lungs. Results: p53 and bcl-2 overexpression showed no association with Fas expression. Conclusively, reduced membranous Fas expression as a mechanism of apoptotic resistance is considered to play an important part of the pulmonary carcinogenesis, which may predict poor survival and have a negative prognostic influence. Conclusion: Increased FasL expression is thought to be a basis for the immune evasion in NSCLCs. The rare bcl-2 overexpression suggests that this anti-apoptotic protein is unlikely to play a role in the apoptotic resistance of NSCLCs.     

骨肉瘤中p53、p21WAF1、cyclinA蛋白的表达及其意义

目的探讨骨肉瘤中p53、p21WAF1、cyclinA蛋白的表达及相互关系.方法应用免疫组化方法对骨肉瘤组织及正常软组织中p53、p21WAF1、cyclinA的蛋白表达进行检测.结果正常软组织中p53表达均阴性,28%(14/50)骨肉瘤中可检测到p53蛋白的异常积累;正常软组织中均有不同程度的p21WAF1蛋白的阳性表达,52%(26/50)骨肉瘤p21WAF1阴性,骨肉瘤中p21WAF1的蛋白表达表现为p53蛋白依赖性的方式;正常组织中cyclinA为阴性,75.6%(28/37)骨肉瘤中存在cyclinA蛋白过表达,cyclinA与p21WAF1的表达呈负相关(r=-0.874,P＜0.01);p21WAF1蛋白的表达与骨肉瘤的分化呈正相关(r=0.687,P＜0.01).结论p53蛋白的异常积聚、p21WAA1的失表达及cyclinA的过表达参与了骨肉瘤失控的增生及肿瘤的形成.     

Clinical relevance of immunohistochemical expression of p53-targeted gene products mdm-2, p21 and bcl-2 in breast carcinoma

The present study was designed to investigate the clinical/prognostic relevance of immunohistochemical expression of p53-targeted genes mdm-2, p21WAF1 and bcl-2 alone and in combination with p53 for the indirect assessment of p53 gene status in breast cancer. 141 archival breast carcinomas were immunostained, and the putative mutational status of the p53 gene was defined in 21 of them, as a control for immunohistochemistry, using the polymerase chain reaction single-strand conformational polymorphism (PCR-SSCP) analysis. Genetic changes of p53 correlated significantly with p53 protein overexpression (p = 0.01) but did not do so with any of the related molecules. Immunohistochemical p53 status was directly correlated with mdm-2 (p = 0.0001), p21 (p = 0.0004) and inversely with bcl-2 (p = 0.005) expression. bcl-2 proved to be an independent marker of prognosis, p53 only in the group of node-positive carcinomas, whereas bcl-2-/p53+ tumours revealed the worst prognosis. Mdm-2 and p21 expression was of prognostic significance neither alone nor in combination. We conclude that the detection of down-stream regulators of p53 does not increase the efficacy of immunohistochemistry in assessing the functional status of p53 in breast cancer; however, their combined analysis may help to select subgroups of patients at the extremes of risk for recurrence, or those with greater chances for survival.     

股骨头骨骺缺血性坏死模型兔构建及组织病理学变化和p53与bcl-2的表达

背景：研究表明儿童股骨头骨骺缺血性坏死(Perthes病)的发病与儿童股骨头血液供应、髋关节周围病变、外伤、内分泌因素、遗传等多种原因有关。 目的：建立可靠的Perthes病的动物模型,并观察其股骨头组织学变化、细胞凋亡情况及p53和bcl-2基因的表达,并探讨凋亡基因p53和bcl-2与Perthes病的的相关性。 方法：采用C型臂透视下经右侧股骨颈注射TH胶致骺板缺血,建立幼兔Perthes病模型,并以同样方法用经右侧股骨颈给予注射生理盐水的兔作对照,于建模后4,6,8,10,12周分别取模型组和对照组两组右侧股骨头做病理切片,观察两组髋关节骺板细胞凋亡情况,并观察两组右侧股骨头p53和bcl-2等凋亡基因表达阳性率的变化。 结果与结论：建模后4周开始出现模型组右侧髋关节关节间隙增宽,出现点状出血变性区并逐步扩大,随后关节软骨与骨骺的黏附强度下降,骨质松脆,干骺端疏松变软。模型组右侧股骨头骺板细胞凋亡率与p53基因表达阳性率呈明显正相关性(r =0.68, P < 0.05),与bcl-2基因表达阳性率之间呈明显负相关性(r =-0.75, P < 0.01)。实验建立的perthes病动物模型稳定,简单,无反复现象。结果证实了Perthes病的发生与p53和bcl-2凋亡基因相关。     

Expression of p53, p21 and bcl-2 in prognosis of lung carcinomas

Expression of suppressor genes 53 and bcl-2 as well as of protein p21 (partly induced by p53 gene) was analyzed in a group of 77 resection specimens and bronchial excision of lung carcinomas (of all basic histological types--squamous cell, neuroendocrine, adenocarcinoma, undifferentiated). Simultaneously the relation of tumor immunophenotype and level of differentiation, cell death and 2-year-survival of patients was evaluated. Gene p53 showed non-only an expected strong expression in squamous cell carcinomas but especially in adenocarcinomas, which were newly characterized by exceptional hyper-expression of p53 in lowly differentiated variants. Expression level of protein p21 and gene p53 was parallel only in adenocarcinomas and undifferentiated carcinomas but discordant in squamous cell and neuroendocrine carcinomas. Positivity of p21 slightly prevailed in well-differentiated variants of the histological types but an exceptional positivity was found even in all the undifferentiated carcinomas. Gene bcl-2 revealed a paradox of strong expression in lowly differentiated neuroendocrine and undifferentiated carcinomas. The level of bcl-2 expression in squamous cell carcinomas was found higher than in references. Among tumors with cell death there was an inverted relation of bcl-2 and p53 expression (high/low) in neuroendocrine carcinomas but both of them were mostly negative in squamous cell carcinomas. A more frequent 2-year-survival of squamous cell carcinomas was verified for bcl-2 positive tumors and newly for p53 positive squamous cell carcinomas. Evaluation of the expression of p53, p21 and bcl-2 in lung carcinomas is so equivocal that its prognostic usage was found to be only complementary to the direct immunohistochemical investigation of the growth activities.     

bcl-2和p53表达在结直肠癌预后评估中的价值

目的　探讨bcl 2和 p5 3表达水平与结直肠癌肿瘤生物学特征及其预后的关系。 方法　应用免疫组化S P法 ,检测93例结直肠癌标本中bcl 2与p5 3蛋白的表达 ,并与临床病理特征进行相关分析。结果　bcl 2蛋白在结直肠癌的阳性表达率为 5 7 0 % (5 3/ 93) ,与淋巴结转移呈负相关 (P <0 0 1) ,p5 3表达阳性率为 4 3% (4 0 / 93) ,与淋巴结转移无相关 (P >0 0 5 ) ,但p5 3表达阳性患者的预后差于 p5 3阴性组 (P =0 0 1)。当分析bcl 2和 p5 3联合表达时 ,Dukes分期及淋巴结转移各组间有差异 (P <0 0 5 )。其中bcl 2 (+) / p5 3(- )表达形式多见于DukesA和B期肿瘤 (4 1 0 % ,2 3/ 5 6 )。经Cox模型多因素分析结果表明 ,淋巴结转移 (P <0 0 1)和 p5 3表达 (P <0 0 1)是结直肠癌独立预后影响因素。其他指标 ,包括bcl 2和 p5 3联合表达情况等均未显示出统计学意义。结论　bcl 2和p5 3表达水平可提示结直肠癌的生物学行为 ,但bcl 2的表达与淋巴结转移状况相关不是一个单独作用的预后指标 ,而 p5 3虽与其它生物学特性关系不大 ,却是一个相对独立的结直肠癌预后指标。