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P21蛋白对阴茎癌淋巴结肿大的诊断价值 |
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朱德淳 李然伟 刘禄成
摘 要：目的：探讨阴茎癌淋巴结肿大与ras癌基因P21蛋白的相关性。方法：采用免疫组化ABC法检测110枚腹股沟淋巴结中ras癌基因产物P21蛋白的表达状况，其中病理检查证实癌性和炎性肿大淋巴结各40枚，正常淋巴结80枚。结果：P21蛋白在癌性、炎性和正常淋巴结中的阳性率分别为92.5%、22.5%和0；在炎性淋巴结中，P21蛋白阳性者平均6个月和17个月出现局部复发和骨盆转移。结论：检测P21蛋白表达状况，可提高癌前状态或癌前病变的诊断水平。
关键词：阴茎癌 淋巴结肿大 P21蛋白 免疫组织化学
Expression of ras-p21 protein in inguinal lymph nodes metastasis of human penis tumor and its clinical significance
ZHU De-chun LI Ran-wei LIU Lu-cheng
（Department of Urology, the 2rd Teaching Hospital, Norman Bethuen University of Medical Sciences, Changchun,130041）
Abstract：Purpose:To investigate the expression of Ras-p21 protein in inguinal lymph nodes metastasis of human penis tumor and its clinical significance. Methods: Expression of ras oncogene product p21 protein in 110 specimens of inguinal lymph nodes were determined by immunohistochemical technique (ABC method). Results: Among these lymph nodes there were 40 of metastasis of cancer, 40 of inflammation and 30 of normal nodes. The positive rate of p21 protein was 92.5%,22.5% and 0% respectively in these three groups. The patients of penis cancer with inflammation lymph nodes in which p21 protein was detected positive had poor prognosis. These patients would have local recurrence within half a year after operation and pelvic metastasis within 17 months on average.Conclusions:The determination of P21 protein may be helpful in the diagnosis of premalignant situation.
Key words：Penis cancer Lymph nodes Ras-p21 Immunohistochemy▲
P21蛋白被认为是一个特异性较高的肿瘤抗原，而免疫组织化学ABC法则被认为是目前对癌基因蛋白进行细胞内定位和定性的优选方法〔1〕。近年来，有关泌尿系肿瘤癌基因蛋白表达的报道较多，而有关癌基因蛋白在器官转移癌或淋巴结转移癌中的表达情况尚未见报告。为探讨阴茎癌淋巴结肿大与ras癌基因P21蛋白的相关性，我们收集了110枚不同病例同一部位的淋巴结，采用免疫组织化学ABC法从癌基因水平评价P21蛋白表达与淋巴结生物学行为之间的关系，为至今尚有争论的阴茎癌患者腹股沟淋巴结处理时机的选择提供理论依据。
1 资料与方法
1.1 标本来源
选取49例阴茎鳞状细胞癌，其中35例阴茎海绵体受侵，18例就诊时疑有腹股沟淋巴结转移，肿瘤直径在2～5 cm之间。距瘤体2 cm处切除肿瘤，对病理检查提示有淋巴结转移者施行淋巴结清扫或术后放射治疗，然后从中选取80枚淋巴结(取自腹股沟部位)，其中病理检查证实癌性和炎性淋巴结各[1] [2] 下一页
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