p53蛋白和ki-67蛋白在食管鳞癌、癌前病变的表达及其临床意义

目的探讨食管鳞癌、癌前病变、正常黏膜p53蛋白和ki-67蛋白的表达及临床意义。方法应用免疫组织化学SP法检测35例食管鳞癌、18例轻度不典型增生、11例重度不典型增生、18例食管正常上皮p53蛋白和ki-67蛋白的表达。结果正常黏膜及轻度不典型增生与重度不典型增生、食管鳞癌p53阳性率比较差别有统计学意义（P〈0．01），正常黏膜与轻度不典型增生之间、重度不典型增生与食管鳞癌p53阳性率比较差别无统计学意义（P〉0．05），p53表达与鳞癌分级及淋巴结转移无关（P〉0．05）。正常黏膜与轻度不典型增生、轻度不典型增生与食管鳞癌ki-67阳性检出率比较有统计学意义（P〈0．05，P〈0．01）、轻度不典型增生与重度不典型增生ki-67阳性检出率比较无统计学意义（P〉0．05），重度不典型增生与食管鳞癌、中-高分化鳞癌与低分化鳞癌ki-67高表达率比较有统计学意义（P〈0．01，P〈0．05），ki-67表达与淋巴结转移无关（P〉0．05）。p53与ki-67表达呈正相关（P〈0．01）。结论p53基因的缺失或突变在食管鳞癌的早期阶段；联合检测P53与ki-67作为筛选癌前高危个体可能更有意义。

Expression of p53 Protein and ki-67 Protein in Esophageal Squamous Carcinoma, Precancerous Lesion and Its Clinical Significance

Objective To investigate the expression of p53 protein and ki-67 protein in esophageal squamous carcinoma, precancerous lesion, normal esophageal epithelium and their clinical significance. Methods 35 cases of esophageal squamous carcinoma,18 cases of mild dysplasia, 11 cases of severe dysplasia, 18 cases normal esophageal epithelium were examined by immunohistochemical S-P methods. Results The positive expression rate of p53 in severe dysplasia, esophageal squamous carcinoma were significant higher than that in normal esophageal epithelium and mild dysplasia(P<0.01), no significant difference of p53 positive expression ratewere found between normal esophageal epithelium and mild dysplasia, between severe dysplasia and esophageal squamous carcinoma(P>0.05), the expression of p53 had no significant relation with lymph node metastasis and histological grades(P>0.05). Significant difference of ki-67 expression were found between normal esophageal epithelium and mild dysplasia, between mild dysplasia and esophageal squamous carcinoma(P<0.05, P<0.01), ki-67 in esophageal squamous carcinoma were significant higher than that in severe dysplasia and in well-moderately differentiated groups(P<0.01, P<0.05). Expression of ki-67 had no significant relation with lymph node metastasis(P> 0.05 ). p53 expression were found significant association with ki-67 expression(P<0.01). Conclusion Deletion or mutation of p53 in the early stages of esophageal squamous carcinoma, combined assay two markers may be more significant in selection of high danger individual of precancerous lesion.