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目的研究增殖指标Ki-67蛋白和p53蛋白在人肝胆管上皮内瘤变及癌变中的表达及其诊断意义。方法运用免疫组织化学S-P方法检测70例肝胆管上皮内瘤变及癌变(低级别肝胆管上皮内瘤变42例,高级别上皮内瘤变28例,高级别中癌变16例)组织中Ki-67蛋白和p53蛋白的表达情况。结果 (1)肝胆管上皮癌变组织中Ki-67的增殖指数为20.65±7.62,明显高于肝胆管上皮内瘤变(P<0.05),并随肝胆管上皮增生程度的增加其增值指数也增高。(2)在16例肝胆管癌变组织中p53蛋白的增值指数为14.73±5.57,明显高于胆管上皮内瘤变组织的蛋白表达(P<0.05)。结论从肝胆管上皮内瘤变到癌变这一发展过程中,Ki-67及p53蛋白增值指数随着细胞增生程度而增高,为临床判断病变程度提供了较具体可靠的参考依据。
Objective To study the expression of Ki-67 and p53 proteins in human hepatobiliary intraepithelial neoplasia and carcinogenesis and their diagnostic significance. Methods Immunohistochemical SP method was used to detect the expression of Ki- and C-terminal in 70 cases of hepatobiliary intraepithelial neoplasia and carcinogenesis (42 cases of low grade hepatobiliary intraepithelial neoplasia, 28 cases of high grade intraepithelial neoplasia and 16 cases of high grade carcinogenesis) 67 protein and p53 protein expression. Results (1) The proliferation index of Ki-67 in hepatocellular carcinoma was 20.65 ± 7.62, which was significantly higher than that in hepatobiliary intraepithelial neoplasia (P <0.05), and also increased with the increase of hepatobiliary epithelial hyperplasia . (2) The value-added index of p53 protein in the tissues of 16 cholangiocarcinomas was 14.73 ± 5.57, which was significantly higher than that of cholangiocarcinoma (P <0.05). Conclusions From the intrahepatic bile duct intraepithelial neoplasia to the carcinogenesis, Ki-67 and p53 protein proliferation index increase with the degree of cell proliferation, which provides a more specific and reliable reference for the clinical judgment of the degree of lesion.