P27~(Kipl)与Ki-67抗原在结直肠腺瘤、腺癌组织中的表达及意义

目的　通过检测P2 7Kipl及Ki 6 7抗原在结 (直 )肠腺瘤、腺癌中的表达 ,探讨其与临床病理指标及预后的关系。方法　采用免疫组织化学方法检测了 2 0例正常结 (直 )肠粘膜、16例腺瘤、6 2例腺癌的P2 7Kipl及Ki 6 7抗原的表达。结果　正常粘膜、腺瘤至腺癌的等级与P2 7Kipl表达等级呈负相关 ,而与Ki 6 7抗原表达等级呈正相关。腺瘤与腺癌细胞质P2 7Kipl表达有显著性差异 (P <0 .0 5 )。腺癌组P2 7Kipl表达与Ki 6 7抗原表达、肿瘤有无转移、Dukes’分期及国际TNM分期呈负相关 ;Ki 6 7抗原表达与有无转移呈正相关。P2 7Kipl表达阳性腺癌患者无病生存时间长于表达阴性者。结论　在结 (直 )肠肿瘤的发生、发展及转移过程中 ,P2 7Kipl表达下调 ,Ki 6 7抗原表达上调 ;P2 7Kipl表达对评估结 (直 )肠癌患者预后有一定帮助。

P27Kipl and Ki-67 antigen expression in human colorectal adenoma and adenocarcinoma and its significance

Objective To study the P27 Kipl and Ki-67 antigen expression in colorectal adenomas and adenocarcinomas, and to find out the relationship between the expression level and clinico-pathological charateristics and prognosis in adenocarcinoma cases. Methods Immunohistochemistry technique was used to investigate P27 Kipl and Ki-67 antigen expression at protein level in 20 cases of normal colorectal mucosa, 16 cases of adenoma and 62 cases of adenocarcinoma.Results P27 Kipl expression grades negatively correlated with these grades: normal tissue, adenoma, adenocarcinoma (r=-0.6562, P=0.001), whereas Ki-67 antigen expression grades correlated with them positively (r=-0.6835, P=0.001). In addition, adenomas showed higher cytoplasmic P27 Kipl expression than that of adenocarcinomas ( χ 2=4.122, P<0.05).In adenocarcinoma, the inverse correlation was found out between P27 Kipl expression grade and the grades of Ki-67 antigen expression (r=-0.454,P<0.001), dukes' stage (r=-0.395, P<0.001),TNM stage (r=0.015).The patients with P27 Kipl expression (+) demonstrated better disease-free survival than those with P27 Kipl (-) (P=0.0171).Conclusion P27 Kipl and Ki-67 antigen may play an important role in colorectal tumorgenesis and colorectal adenocarcinoma metastasis, respectively. Refering to cytoplasmic P27 Kipl expression may be helpful to distinguish colorectal adenoma and adenocarcinoma. P27 Kipl expression may contribute to evaluating the prognosis of colorectal adenocarainoma patients.