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目的:定性和定量分析p16蛋白在食管癌及癌前病变组织中的表达,探讨其与食管癌发生发展的关系。方法:应用免疫组化及流式细胞术(FCM),检测p16蛋白在食管癌及癌前病变组织中的表达。结果:1)从鳞状上皮→不典型增生(癌前病变)→原位癌→浸润癌,随着病变加重,p16蛋白表达呈逐渐降低趋势。2)免疫组化结果显示:正常组与不典型增生Ⅰ级组p16蛋白表达差异无显著性(P>0.05),与其余各组差异有显著性(P<0.05);浸润癌组与正常组、不典型增生Ⅰ级组差异均有显著性(P<0.05),与其余组差异无显著性(P>0.05)。3)FCM结果:不典型增生Ⅱ级组与正常组p16蛋白表达量差异有显著性(P<0.001),不典型增生Ⅱ级、Ⅲ级组间差异有显著性(P<0.05),不典型增生Ⅲ级与食管癌组间差异无显著性(P>0.05)。结论:p16蛋白表达缺失在食管癌变过程早期阶段就已经发生,随着病变发展p16蛋白阳性表达率逐渐降低,其表达缺失可能在食管癌发生、发展及转归过程中起重要作用。
OBJECTIVE: To qualitatively and quantitatively analyze the expression of p16 protein in esophageal cancer and precancerous lesions, and to explore its relationship with the development of esophageal cancer. Methods: Immunohistochemistry and flow cytometry (FCM) were used to detect the expression of p16 protein in esophageal cancer and precancerous lesions. Results: 1) From squamous epithelium to atypical hyperplasia (precancerous lesion) to carcinoma in situ to invasive carcinoma, the expression of p16 protein gradually decreased as the disease progressed. 2) The results of immunohistochemistry showed that there was no significant difference in p16 protein expression between the normal group and the atypical hyperplasia group I (P>0.05), and there was a significant difference between the other groups (P<0.05); invasive carcinoma group and normal group There was significant difference between the atypical hyperplasia grade I group (P<0.05) and no significant difference with other groups (P>0.05). 3) FCM results: There was a significant difference in the expression of p16 protein between the atypical hyperplasia II group and the normal group (P<0.001), and there was a significant difference between the grade II and III dysplasia group (P<0.05). There was no significant difference between hyperplasia grade III and esophageal cancer group (P>0.05). Conclusion: The loss of p16 protein expression has already occurred in the early stage of esophageal carcinogenesis. With the development of lesions, the positive expression rate of p16 protein gradually decreases. The loss of p16 protein expression may play an important role in the occurrence, development and prognosis of esophageal cancer.