【作者】 周刚；

【导师】 陈湘；

【作者基本信息】 中南大学 ， 外科学， 2008， 硕士

【摘要】 目的:研究Ki-67与P27在良恶性肾上腺皮质肿瘤中的表达情况,探讨它们作为鉴别良恶性肾上腺皮质肿瘤的生物学参考指标的可行性。方法:采用免疫组化法(SP),检测12例正常肾上腺,10例肾上腺皮质腺癌,60例肾上腺皮质腺瘤中Ki-67与P27的表达,并分析它们的表达情况与良恶性肾上腺皮质肿瘤之间的关系。结果:1.ki-67在正常肾上腺皮质、肾上腺皮质腺瘤、肾上腺皮质腺癌中的表达:(1)正常组与腺瘤组比较无显著差异(P=0.761＞0.05)。(2)正常组与腺癌组比较有显著差异(P=0.003＜0.05)。(3)腺瘤组与腺癌组比较有显著差异(P=0.001＜0.05),且阳性表达率腺癌组(80%)高于腺瘤组(13.33%)。2.P27在正常肾上腺皮质、肾上腺皮质腺瘤、肾上腺皮质腺癌中的表达:(1)正常组与腺瘤组比较无显著差异(P=0.512＞0.05)。(2)正常组与腺癌组比较有显著差异(P=0.006＜0.05)。(3)腺瘤组与腺癌组比较有显著差异(P=0.001＜0.05),且阳性表达率腺瘤组(91.97%)高于腺癌组(40%)。3.对ki-67LI与P27LI进行等级相关分析,结果显示,r=-0.63,P＜0.05,有统计学意义,提示ki-67LI与P27LI呈负相关,即在各组的表达中,Ki-67LI越高P27LI越低。4.Ki-67LI在肾上腺皮质腺瘤组与腺癌组中,有显著差异(P＜0.01),且腺癌组(11.47%)高于腺瘤组(2.64%)P27LI在肾上腺皮质腺瘤组与腺癌组中,有显著两者差异(P＜0.01),且腺瘤组(20.36%)高于腺癌组(10.11%)提示Ki-67LI与P27LI在腺瘤组和腺癌组中的差异均有统计学意义。结论:检测Ki-67和P27可能为鉴别良恶性肾上腺皮质肿瘤提供辅助生物学参考指标。联合检测Ki-67和P27可能提高鉴别良恶性肾上腺皮质肿瘤的敏感性,可以考虑将Ki-67LI＞4%,P27LI＜13%作为肾上腺皮质肿瘤恶性倾向大的辅助参考标准。更多还原

【Abstract】 Objective:To study the expression of Ki-67,P27 in adrenocortical tumors,and its relationship with adrenocortical carcinoma and adrenocortical adenoma.Methods:The methods of S-P Immunohistochemistry was used to detect the expression of Ki-67.P27 in adrenocortical carcinoma(10cases),adrenocortical adenoma(60cases)and normal adrenocortical tissue(12cases).and the expression of Ki-67.P27 was analyzed with relation to adrenocortical carcinoma and adrenocortical adenoma.Results:1.There is significant difference in the expression of Ki-67 between adrenocortical carcinoma and adrenocortical adenoma,and the positive rate of adrenocortical carcinoma is significant higher than that in adrenocortical adenoma.2.There is significant difference in the expression of P27 between adrenocortical carcinoma and adrenocortical adenoma,and the positive rate of adrenocortical carcinoma is significant lower than that in adrenocortical adenoma.3.There is the highest expression of Ki-67 and the lowest expression of P27 in adrenocortical tumors.There exist negative correlation between the expression of Ki-67 and P27(P＜0.05).There is significant difference in the LI of Ki-67 and that of P27 between adrenocortical carcinoma and adrenocortical adenoma(P＜0.01).The cutpoint of LI of Ki-67 was 4%and the cutpoint of P27 was 13%in adrenocortical carcinoma.Conclussions:It is suggested that combine detecting the expression of Ki-67 and P27 may be taken as one of biomarkers for differentiation of adrenocortical adenomas from adrenocortical carcinomas.The LI of Ki-67 above 4%and LI of P27 below 13%,is a sensitive indicator of adrenocortical carcinoma.更多还原