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目的探讨腺性膀胱炎的良恶性及癌变可能性,并探讨临床分型的合理性。方法根据膀胱镜下表现将腺性膀胱炎分为低危型及高危型。25例腺性膀胱炎新鲜组织,其中低危型12例,高危型13例,用流式细胞术检测其DNA含量;38例腺性膀胱炎蜡块组织,其中低危型20例,高危型18例,用免疫组织化学的方法研究增殖细胞核抗原(PCNA)、突变型p53、p21ras、bcl2及Rb等的表达。结果正常二倍体DNA指数为1.00±0.03,低危型腺性膀胱炎组为1.01±0.05,高危型组为1.05±0.07,低危型组和高危型组之间的差异无统计学意义(t=1.639,P=0.115);PCNA及p53在低危型组均表达阴性,在高危型组分别表达5例(27.8%)及4例(22.2%),两组之间的差异有统计学意义(P值分别为0.017、0.041);p21ras、bcl2及Rb在低危型组和高危型组的表达差异无统计学意义。结论高危型腺性膀胱炎和低危型腺性膀胱炎同为良性病变。高危型有发生恶变的可能性,因此将腺性膀胱炎分为高危型及低危型具有合理性。p53基因可能在高危型腺性膀胱炎的恶变过程中有重要作用。
Objective To investigate the benign and malignant glandular cystitis and the possibility of cancer, and discuss the rationality of clinical classification. Methods According to the cystoscopic glandular cystitis will be divided into low-risk type and high-risk type. 25 cases of glandular cystitis fresh tissue, including 12 cases of low-risk type, high-risk type in 13 cases, DNA content was detected by flow cytometry; 38 cases of cystitis glandular tissue, including 20 cases of low-risk type, 18 cases, the expression of proliferating cell nuclear antigen (PCNA), mutant p53, p21ras, bcl2 and Rb were studied by immunohistochemistry. Results The normal diploid DNA index was 1.00 ± 0.03, 1.01 ± 0.05 in low-risk cystitis glandularis and 1.05 ± 0.07 in high-risk group, and there was no significant difference between low-risk group and high-risk group t = 1.639, P = 0.115). PCNA and p53 were negatively expressed in low-risk group, 5 cases (27.8%) and 4 cases (22.2%) in high-risk group, respectively. There was statistical difference between the two groups (P = 0.017, 0.041, respectively). There was no significant difference in the expression of p21ras, bcl2 and Rb between low risk group and high risk group. Conclusions Both high-risk glandular cystitis and low-risk glandular cystitis are benign lesions. High-risk type has the possibility of malignant transformation, so divided into high-risk glandular cystitis and low-risk type is reasonable. p53 gene may play an important role in the malignant transformation of high-risk glandular cystitis.