【作者】 马文亮；

【导师】 刘放；

【作者基本信息】 大连医科大学 ， 肿瘤学， 2008， 硕士

【摘要】 目的:通过检测大肠癌与癌旁组织中c-erbB-2、bcl-2、bax和p53蛋白的表达,分析其在大肠癌中的表达及其临床意义。材料与方法:2007年12月至2008年3月,辽宁省肿瘤医院大肠科手术切除的大肠癌标本75例,男44例,女31例,年龄30-78岁,平均年龄54±4.6岁。术前明确临床分期,入院前均未行放、化疗及免疫等抗肿瘤治疗,无二次手术史。取癌组织和癌旁组织(距癌组织超过5 cm)各1份,经免疫组织化学方法(S-P法)检测癌组织及癌旁组织中c-erbB-2、bcl-2、bax和p53蛋白的表达。采用卡方检验分析实验数据,P<0.05认为有统计学差异。结果:c-erbB-2蛋白主要表达在癌组织细胞膜,呈现明显棕黄色颗粒,其表达阳性率为50.7 % (38/ 75),癌旁组织无表达;bcl-2蛋白表达在癌组织及癌旁组织的细胞浆及细胞膜均呈阳性表达,表现为棕黄色颗粒,呈灶性或弥漫分布,其阳性率分别为61.3% (46/ 75), 10.7% (8/ 75);bax蛋白表达在癌组织及癌旁组织的细胞浆呈阳性表达,表现为细胞浆出现棕黄色颗粒,呈弥漫性或灶性分布,阳性率为46.7 % (35/ 75), 81.3% (61/ 75);p53蛋白主要表达于细胞核,呈清晰棕色,阳性率为52.0%(39/ 75),癌旁组织无表达。统计分析显示:c-erbB-2阳性表达与肿瘤的大小有显著性差异,与年龄、性别、肿瘤的组织类型、浸润深度、大体分型之间无差异; bcl-2蛋白表达与大肠癌患者的淋巴结转移、Dukes分期有显著性差异,与年龄、性别、肿瘤的组织类型、浸润深度、大体分型之间无差异;bax和p53蛋白表达与大肠癌的各项临床指标无显著差异。癌组织与癌旁组织间四种基因产物表达的差异均具有显著性。结论:1,c-erbB-2阳性表达与肿瘤的大小有显著性差异,与年龄、性别、肿瘤的组织类型、浸润深度、大体分型之间无差异; 2,bcl-2蛋白表达与大肠癌患者的淋巴结转移、Dukes分期有显著性差异,与年龄、性别、肿瘤的组织类型、浸润深度、大体分型之间无差异;3,bax和p53蛋白表达与大肠癌的各项临床指标无显著差异;4,癌组织与癌旁组织间四种基因产物表达的差异均具有显著性。更多还原

【Abstract】 Objective: To analyze the expression and clinical significance of c-erbB-2、bcl-2、bax and p53 in colorectal cancer by detecting their expression in cancerous and adjacent tissues(> 5cm from the cancerous tissue).Methods: Examples of 75 cases of colorectal cancer who were treated in tumor hospital of Liaoning province from December 2007 to March 2008 ,Male 44,female 31,aged from 30 to78 years old and 54±4.6 for average. Each part respectively in cancerous and adjacent tissues (> 5cm from the cancerous tissue). The clinical stages were identified prior to operation. All patients have not received any treatment before. The expression of c-erbB-2、bcl-2, bax and p53 protein in all case were detected by immune histochemistry (S-P).The photographs of S-P were taken by microscope and the data were examined by chi-square test .Results: The positive expression of c-erbB-2 protein in this group of 75 cases of cancerous tissues was 50.7 % (38/75), with performance of yellowish brown pellet in the cell membrane.adjacent tissues was negative;The positive expression of bcl-2 protein in this group of 75 cases of cancerous tissues was 61.3% (46/ 75), Adjacent tissues was 10.7% (8/ 75) ,with performance of yellowish brown pellet in cytoplasma and cell membrane, distribution of focus or diffuse; The positive expression of bax protein in this group of 75 cases of cancerous tissues was 46.7 % (35/ 75), adjacent tissues was 81.3% (61/ 75), existing in the form of the yellowish brown pellet in the cytoplasma, distribution of focus or diffuse. The positive expression of p53 protein in this group of 75 cases of cancerous tissues was 52.0%(39/ 75), adjacent tissues was negative ,mainly located in the cell nucleus,with clear brown color of cell nucleus; The statistical analysis demonstrated the expression of c-erbB-2 had no significant differences with age、gender、and tissue type, only had significant differences with size ( P<0.05 ) ;Expression of bcl-2 had significant differences with metastasis of lymph node, Dukes’ staging(P<0.05); The expression of bax and the p53 protein had no significant differences with the clinical index of colorectal cancer (P > 0. 05); the four gene expressions had a positive rate between cancerous and adjacent tissues (P<0.05).Conclusion:1, The expression of c-erbB-2 had no significant differences with age、gender、and tissue type metastasis of lymph node、Dukes’ staging, only had significant differences with size;2, Expression of bcl-2 had significant differences with metastasis of lymph node , Dukes’ staging;3, The expression of bax and the p53 protein had no significant differences with the clinical index of colorectal cancer;4, The four gene expression had a positive rate between cancerous and adjacent tissues.更多还原