【摘要】 目的:探讨p53、p21、Ki-67和VEGF的表达与膀胱癌的病理分级、分期以及预后是否相关。方法:应用免疫组织化学染色的方法,对40例手术证实的膀胱移行细胞癌患者的病理切片进行p53、p21、Ki-67和VEGF的化学染色。将免疫组化结果与病理分级、分期以及预后情况进行分析。结果:在40个肿瘤标本中,p53、p21、Ki-67和VEGF的表达有改变的分别有31个(77.5%),22个(55.0%),16个(40.0%),17个(42.5%);其中至少1个标记物表达异常35例(87.5%),而4个标记物均表达异常者有7例(17.5%)。患者平均随访51个月。除了Ki-67、VEGF与病理分级以及Ki-67与分期之间无统计学意义外,4个标记物多少都与膀胱癌的病理分级、分期相关。p53(+)/p21(-)以及4个标记物同时异常是与疾病相关死亡率有关的独立因素(P<0.05,P<0.01)。而Ki-67、VEGF均不是膀胱癌相关死亡率的独立因素(P>0.05)。越多标记物表达异常,则膀胱癌的死亡率增加。结论:p53、p21、Ki-67和VEGF多少都与膀胱癌的病理分级、分期相关。联合检测p53、p21、Ki-67和VEGF可以更加准确地预测膀胱癌的预后。更多还原

【Abstract】 Objective:To evaluate the relationship of expression of p53,p21,Ki-67,VEGF and bladder cancer stage,grade and prognosis.Methods:The expressions of p53,p21,Ki-67 and VEGF in forty specimens from 40 patients of bladder cancer were studied by means of immunohistochemistry.The immunostaining results were analyzed in relation to the tumor stage,grade and compared with the clinical parameters of prognosis.Results:Changes in expression of p53,p21,Ki-67 and VEGF were noted in 31(77.5%),22(55%),16(40%)and 17(42.5%)tumors,respectively.Thirty-five patients(87.5%)had at least one marker altered,and 7 patients(17.5%)had all four altered.The patients were followed-up for 51 months by median.Abnormal expressions of p53,p21,Ki-67 and VEGF were found associated with bladder cancer stage and grade.Multivariate analysis indicates that the combined abnormal expressions of four markers or p53(+)/p21(-)provided prognostic information in bladder cancer(P<0.01,P<0.05,respectively).Ki-67 or VEGF wasn’t independently associated with prognostic information in bladder cancer.The incremental number of altered markers was independently associated with an increased risk of bladder cancer mortality.Conclusions:Abnormal expressions of p53,p21,Ki-67 and VEGF expression were almost associated with bladder cancer stage and grade.The combined evaluation of p53,p21,Ki-67 and VEGF is useful in prognosis of bladder cancer.更多还原