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目的探讨Ｐ５３与细胞增殖核抗原（ＰＣＮＡ）在儿童恶性脑胶质瘤表达的预后价值。方法采用ＡＢＣ免疫组化方法对３３例儿童恶性脑胶质瘤Ｐ５３与ＰＣＮＡ表达进行回顾性研究。结果３３例儿童恶性脑胶质瘤中Ｐ５３表达阳性１５例（４５％），ＰＣＮＡ表达阳性２９例（８８％）。间变性星形细胞瘤、胶质母细胞瘤及髓母细胞瘤Ｐ５３蛋白表达的阳性比例分别为５／１２、９／１６、１／５，肿瘤Ｐ５３蛋白阴性者其细胞增殖活性均较阴性者高（Ｐ＜００５）；ＰＣＮＡ标记指数与肿瘤的恶性程度呈正相关（Ｐｅａｒｓｏｎ列联系数＝０．５６，Ｐ＜００１）。Ｐ５３或ＰＣＮＡ表达阳性者存活率分别显著低于Ｐ５３或ＰＣＮＡ表达阴性者（Ｐ＜００５，Ｐ＜００１）。结论Ｐ５３基因突变以及由此导致的细胞异常增殖与儿童恶性脑胶质瘤的发生和发展有关；ＰＣＮＡ能较好地反映胶质瘤的恶性程度，其表达检测对临床预后判定有重要参考价值。
Objective To investigate the prognostic value of P53 and proliferating cell nuclear antigen (PCNA) expression in children with malignant glioma. Methods The immunohistochemical ABC method was used to investigate the expression of P53 and PCNA in 33 children with malignant gliomas. Results 33 cases (45%) had positive expression of P53 in malignant gliomas and 29 cases (88%) had positive PCNA expression. The positive rates of P53 protein expression were 5/12, 9/16, and 1/5 in patients with atypical astrocytoma, glioblastoma and medulloblastoma, respectively, and those with negative P53 protein were all significantly lower than those with negative P53 protein (P <005). There was a positive correlation between the PCNA labeling index and the malignant degree of the tumor (Pearson’s correlation coefficient = 0.56, P <001). The survival rates of P53 or PCNA positive patients were significantly lower than those of P53 or PCNA negative patients, respectively (P <005, P <001). Conclusions The mutation of P53 gene and the abnormal cell proliferation are related to the occurrence and development of malignant glioma in children. PCNA can better reflect the malignant degree of glioma, and the expression of PCNA is of important reference value for clinical prognosis.