不同胆囊病变树突状细胞浸润的免疫组化研究

应用免疫组化对胆囊不同病变内S-100~ 树突状细胞浸润与肿瘤相关分子的表达相互关系进行对比研究.包括胆囊癌症病人切除标本30例,结石20例,慢性炎症20例.用单克隆抗p53蛋白、抗增殖细胞核抗原(PCNA)、抗癌胚抗原(CEA)及多克隆抗S-100蛋白抗体,LSAB法检查上述病变标本.结果发现癌症病人p53蛋白阳性为46.7%(14/30),PCNA为86.7%(26/30),CEA为30.0%(9/30),S-100~ DC浸润仅为40.0%(12/30);结石标本p~(53)蛋白阴性,PCNA为35.0%(7/20),CEA为15%(3/20),S-100~ DC浸润为50%(10/20);慢性炎病例p53蛋白、CEA均为阴性,PCNA为25%(5/20),而S-100~ DC浸润为 85%(17/20).S-100~ DC浸润病例数与细胞密度,在恶性肿瘤中明显低于非肿瘤良性病变(P<0.05).本研究说明:①炎性病变的上皮组织多属单纯性增生而无肿瘤相关标记分子表达,同时伴有较高的细胞免疫活性;②胆囊结石上皮存在某些不典型变化有少许肿瘤标记分子表达,并伴有机体抗肿瘤免疫反应的下降,易于癌变;③癌症病人标本突变型p53基因过度表达、PCNA明显多曾多及 S-100~ DC明显减少,可能反映了免疫监视系统受损,使肿瘤细胞逃避机体的免疫攻击以促进肿瘤发生与发展.

An Immunohistochemical Study on S-100 Protein Positive Dendritic Cell(S-100) Infiltrated in Tissues Relation to the Expression of Tumor-Related Markers in Different Gallbladder Lesions

The relationship between the infiltrating density of S-100 DC in resected specimen and the expressions of tumor-related markers in various gall bladder lesions including cancer 30. gallstone 20,and chronic inflammation 20 were studied by immunohistochemistry with monoclonal anti-p53 protein,anti-PCNA,anti-CEA,and polyclonal anti S-100 protein antibodies. The results showed : in cancer patients,p53 protein immunostaining 46. 7% (14/30), PCNA 86. 7%(26/30),CEA 30. 0%(9/30) were found; but the s-100 DC was only 40. 0% (12/ 30);ingallstone patients,p53 protein negtive,PCNA 35. 0% (7/20),CEA 15. 0% (3/20), and S-100 DC 50. 0%(10/20) were detected;in flammatory patiens,p53 protein negative, PCNA 25. 0%(5/20),CEA negative,and S-100 DC 85. 0%(17/20) were detected. Present data suggested that: (1 )inflammatory lesions, there was a simple epithelial proliferation, no tumor-related markers expression, but with more higher celluar immunologic competence than other lesions can be found; (2)in gallstone lesions,the epithelum had some atypic-al changes that revealed not only expression of tumor markers but also accompanied with a decline immunoreactivity to tumor that may facilitate the carcinogenesis; (3)in cancer patients, mutant p53 gene over-expression and a clearly cut increasing celluar proliferation may reflect an impairing of immunological competence concerning immunologic surveillance of neoanti-gen-bearing tumor cells that tumor cells could be escaped from immunological attack.