PTEN和P53及P16在不同形态大肠侧向发育型肿瘤中的表达
Chinese Journal of Integrated Traditional and Western Medicine on Digestion(2019)
Abstract
[目的]观察抑癌基因PTEN、P53、P16蛋白在大肠侧向发育型肿瘤(LST)及其三分型中表达变化,探讨3者在LST发展进程中作用.[方法]选取经内镜下ESD治疗切除的90例大肠组织为LST组,另选取同时期80例经内镜下ESD治疗切除的大肠隆起型腺瘤(PA)大肠组织为PA组,以及70例结肠镜检查为全结肠未见器质性病变的患者正常大肠组织为对照组.在内镜下将90例LST分为颗粒均一型(LST-G-H)27例、结节混合型(LST-G-M)25例及非颗粒型(LST-NG) 38例,并比较其临床资料;采用免疫组织化学法(SP法)检测PTEN、P53、P16蛋白水平.[结果]LST及其三亚型患者病变直径均明显大于PA患者(P<0.05).LST病变多分布于直肠,PA病变多位于远端结肠,2者比较差异有统计学意义(P<0.05).LST患者中组织学类型所占比例依次为绒毛状腺瘤、管状绒毛状腺瘤、管状腺瘤、锯齿状腺瘤;PA病变中管状腺瘤所占比例最高,无锯齿状腺瘤;其中,LST-G-H、LST-G-M中以绒毛状腺瘤为主,LST-NG中管状绒毛状腺瘤所占比例最高.LST癌变率显著高于PA(P<0.05).PTEN、P16蛋白表达LST患者最低、PA患者次之、对照组最高;P53蛋白表达LST患者最高、PA患者次之、对照组最低.LST-NG患者PTEN蛋白表达显著低于LST-G-H组、LST-G-M组(P<0.05),P53、P16蛋白阳性率明显高于LST-G-H组、LST-G-M组(P<0.05).[结论]PTEN、P16在LST患者大肠组织中表达下调,P53表达上调,可能参与LST特别是LST-NG发生发展.
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