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目的:探讨术前动脉化疗栓塞对膀胱癌组织Ki-67和增殖细胞核抗原(PCNA)表达的影响及其临床意义。方法:对30例膀胱癌患者化疗栓塞前后的肿瘤组织,应用免疫组织化学法测定Ki-67和PCNA的表达,并分析Ki-67和PCNA与膀胱癌病理分级和临床分期的关系。结果:对30例膀胱癌患者化疗栓塞前后的肿瘤组织,应用免疫组织化学法测定Ki-67和PCNA的表达,并分析Ki-67和PCNA与膀胱癌病理分级和临床分期的关系。结论:化疗栓塞前后Ki-67中高度阳性表达率为70%、26.67%,PCNA为73.33%、20%,差异均有非常显著性意义(P<0.01),经随访24.6个月,复发率为16.67%。Ki-67和PCNA阳性表达及下降幅度与膀胱癌的病理分级、临床分期和患者术后复发率关系密切,两者阳性表达及表达强度呈正相关(P<0.001)。结论:术前化疗栓塞能降低膀胱癌组织Ki-67和PCNA的表达,调节膀胱癌的分化程度,使肿瘤降级降期,减少术后转移,降低复发率,提高生存率。Ki-67和PCNA的表达可作为膀胱癌预后估计的指标。
Objective: To investigate the effect of preoperative arterial chemoembolization on the expression of Ki-67 and proliferating cell nuclear antigen (PCNA) in bladder cancer and its clinical significance. Methods: The expression of Ki-67 and PCNA in 30 patients with bladder cancer before and after chemoembolization was detected by immunohistochemistry. The relationship between Ki-67, PCNA and the pathological grade and clinical stage were analyzed. Results: The expression of Ki-67 and PCNA in 30 bladder cancer patients before and after chemoembolization was detected by immunohistochemistry. The relationship between Ki-67 and PCNA and the pathological grade and clinical stage of bladder cancer was analyzed. Conclusions: The positive rates of Ki-67 before and after chemoembolization were 70%, 26.67%, 73.33%, 20%, respectively. There was a significant difference between the two groups (P <0.01). After a follow-up of 24.6 months, the recurrence rate was 16.67%. The positive expressions of Ki-67 and PCNA were significantly correlated with the pathological grade, clinical stage and the recurrence rate of bladder cancer. There was a positive correlation between the expression of Ki-67 and PCNA (P <0.001). Conclusions: Preoperative chemoembolization can decrease the expression of Ki-67 and PCNA in bladder cancer, regulate the differentiation of bladder cancer, decrease the grade of tumor, decrease the postoperative metastasis, reduce the recurrence rate and increase the survival rate. Ki-67 and PCNA expression can be used as a prognostic indicator of bladder cancer.