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目的：从分子生物学角度探讨胆囊良性病变的癌变潜能以及胆囊癌与多基因改变的关系。方法：应用免疫组化技术，检测５８例胆囊良、恶性病变的ＥＧＦＲ、Ｐ５３、ｂｃ１－２的表达。结果：全部病例均呈ｂｃｌ－２阴性表达；ＥＧＦＲ和Ｐ５３在单纯增生病变、腺瘤、腺癌中的表达率分别是０％、２８％、６２．５％和０％、４２．８％、４３．８％，差异均有显著意义（Ｐ＜０．０１）；ＥＧＦＲ阳性表达与腺癌的分级、转移有关（Ｐ＜０．０５，Ｐ＝０．０４８）；１０／３２腺癌共同表达ＥＧＦＲ和Ｐ５３，统计学分析无显著相关意义（ｒ＝０．００３６、Ｐ＞０．０５）。结论：提示单纯增生性病变无癌变倾向，腺瘤有癌变潜能；Ｐ５３突变、ＥＧＦＲ过度表达与胆囊癌的形成有关，在部分胆囊癌中，两者有协同作用；检测这两个指标有助于胆囊癌的早期诊断和鉴别诊断，后者还有助于腺癌的分级、转移和预后判断。
OBJECTIVE: To investigate the canceration potential of benign gallbladder lesions and the relationship between gallbladder cancer and multiple gene changes from the perspective of molecular biology. Methods: Immunohistochemical technique was used to detect the expression of EGFR, P53 and bc1-2 in 58 cases of benign and malignant gallbladder lesions. Results: The expression of bcl-2 was negative in all cases. The expression rates of EGFR and P53 in simple hyperplasia, adenoma, and adenocarcinoma were 0%, 28%, 62.5%, 0%, and 42.8%, respectively. 43.8%, the difference was significant (P <0.01); EGFR positive expression was related to the grade and metastasis of adenocarcinoma (P <0.05, P = 0.048); 10/32 adenocarcinoma co-expressed EGFR and P53 were not statistically significant (r=0.0036, P>0.05). Conclusions: It is suggested that the proliferative lesions have no tendency of canceration and the adenomas have the potential of canceration. The mutation of P53 and the overexpression of EGFR are related to the formation of gallbladder carcinoma. In some gallbladder carcinomas, they have a synergistic effect. The detection of these two indicators is helpful. Early diagnosis and differential diagnosis of gallbladder cancer, the latter also contribute to the classification, metastasis and prognosis of adenocarcinoma.