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目的:探讨ΔNp63和Ki-67在膀胱移行上皮癌(transitional cell carcinoma of bladder,TCCB)中的免疫组化表达及与膀胱癌病理分级、临床病理分期和预后的相关性。方法:随机选择2006～2007年间56例TCCB和12例正常膀胱黏膜病理切片用SP免疫组化行ΔNp63和Ki-67检测,将结果与病理分级、分期和预后进行分析。结果:ΔNp63和Ki-67在膀胱移行细胞癌中的阳性表达率明显高于正常膀胱黏膜(P<0.05)。ΔNp63和Ki-67在低分化、浸润性癌组织中的阳性表达率明显高于高分化、浅表性癌组织,在膀胱癌的病理分级和临床分期之间表达差异有统计学意义(P<0.05)。ΔNp63和Ki-67在复发病例中的阳性表达率显著高于初发病例(P<0.05)。采用Spearman等级相关性分析对ΔNp63和Ki-67在TCCB中的表达进行比较,ΔNp63与Ki-67呈正相关,rs′为0.316,且P<0.05。结论:ΔNp63和Ki-67与膀胱癌的临床病理分级和分期及预后密切相关,随膀胱癌分化程度的降低和浸润程度的增加而增强。ΔNp63和Ki-67在TCCB的进展中可能有相互协同作用,ΔNp63可能通过促进细胞增殖发挥促癌作用,联合检测ΔNp63和Ki-67可以作为判断TCCB的预后的肿瘤标记物。
Objective: To investigate the immunohistochemical expression of ΔNp63 and Ki-67 in transitional cell carcinoma of bladder (TCCB) and its correlation with pathological grade, clinicopathologic stage and prognosis of bladder cancer. Methods: 56 cases of TCCB and 12 cases of normal bladder mucosa from 2006 to 2007 were randomly selected for the detection of ΔNp63 and Ki-67 by SP immunohistochemistry. The results were compared with the pathological grade, stage and prognosis. Results: The positive rates of ΔNp63 and Ki-67 in bladder transitional cell carcinoma were significantly higher than those in normal bladder mucosa (P <0.05). The positive expression rates of ΔNp63 and Ki-67 in poorly differentiated and invasive carcinoma were significantly higher than those in well differentiated and superficial cancerous tissues, and there was significant difference between the pathological grade and clinical stage of bladder carcinoma (P < 0.05). The positive expression rates of ΔNp63 and Ki-67 in the recurrent cases were significantly higher than those in the initial cases (P <0.05). The Spearman rank correlation analysis of ΔNp63 and Ki-67 in TCCB expression comparison, ΔNp63 and Ki-67 was positively correlated, rs’ was 0.316, and P <0.05. Conclusion: The expressions of ΔNp63 and Ki-67 are closely related to the clinicopathological grade, stage and prognosis of bladder cancer, and they are increased with the degree of differentiation and the degree of infiltration of bladder cancer. ΔNp63 and Ki-67 may play synergistic roles in the progression of TCCB. ΔNp63 may play a role in promoting tumor cell proliferation. Combined detection of ΔNp63 and Ki-67 can be used as tumor markers to predict the prognosis of TCCB.