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目的 研究p16、Rb在胆道良恶性病变中的表达和临床意义。方法 应用免疫组化S-P法测定41例肝外胆管癌中p16、Rb的表达,以13例慢性胆管炎作为对照。结果 肝外胆管癌组p16阳性率为51.2％(21/41)。其中,高中分化癌组、低分化癌组、转移组、无转移组阳性率分别为53.6％(15/28)、46.20k(6/13)、31.3％(5/16)和64.0％(16/25);胆管炎组阳性率为92.3％(12/13)。肝外胆管癌组与胆管炎组间、无转移组与转移组间差异有显著性(P<0.01,P<0.05),高中分化癌组与低分化癌组间差异无显著性(P>0.05)。肝外胆管癌组Rb阳性率为58.5％(24/41)。其中,高中分化癌组、低分化癌组、转移组、无转移组Rb阳性率分别为71.4％(20/28)、30.80%(4/13)、37.5％(6/16)和72.0％(18/25);胆管炎组阳性率为92.3％(12/13)。肝外胆管癌组与胆管炎组间、高中分化癌组与低分化癌组间、无转移组与转移组间差异有显著性(P<0.05)。24例Rb阳性病例中,p16阳性率为37.5％(9/24);17例Rb阴性病例中,p16阳性率为70.6％(12/17),两者表达呈负相关(P<0.05),Kendall相关系数τb=-0.33。结论 肝外胆管癌组织中存在p16、Rb异常表达,均与转移有关,Rb异常表达还与肝外胆管癌病理分级有关。上述两指标可作为判断患者预后的参考指标。
Objective To study the expression and clinical significance of p16 and Rb in benign and malignant biliary lesions. Methods The expression of p16 and Rb in 41 cases of extrahepatic cholangiocarcinoma was detected by immunohistochemical S-P method. Chronic cholangitis of 13 cases was used as control. Results The positive rate of p16 in extrahepatic cholangiocarcinoma was 51.2% (21/41). The positive rates of differentiated cancer, poorly differentiated cancer, metastasis and metastasis in high school were 53.6% (15/28), 46.20k (6/13), 31.3% (5/16) and 64.0% / 25). The positive rate of cholangitis group was 92.3% (12/13). The difference between the extrahepatic cholangiocarcinoma group and the cholangitis group was significant (P <0.01, P <0.05), but there was no significant difference between the high differentiated carcinoma group and the poorly differentiated carcinoma group (P> 0.05 ). The positive rate of Rb in extrahepatic cholangiocarcinoma group was 58.5% (24/41). The positive rates of Rb in high differentiated cancer group, poorly differentiated cancer group, metastasis group and non-metastasis group were 71.4% (20/28), 30.80% (4/13), 37.5% (6/16) and 72.0% 18/25). The positive rate of cholangitis group was 92.3% (12/13). Between the extrahepatic cholangiocarcinoma group and the cholangitis group, there was a significant difference (P <0.05) between the high-grade differentiated cancer group and the poorly-differentiated cancer group, no metastasis group and metastasis group. The positive rate of p16 was 37.5% (9/24) in 24 Rb positive cases. The positive rate of p16 was 70.6% (12/17) in 17 Rb negative cases, the expression of p16 was negatively correlated (P <0.05) Kendall correlation coefficient τb = -0.33. Conclusion Abnormal expressions of p16 and Rb exist in extrahepatic cholangiocarcinoma tissues, both of which are related to metastasis. Abnormal expression of Rb is also associated with pathological grading of extrahepatic cholangiocarcinoma. These two indicators can be used as a reference to determine the prognosis of patients.