p53、VEGF、COX-2和EGFR在膀胱癌组织中表达的相关性及临床意义

摘要

目的 探讨p53、VEGF、COX-2和EGFR在膀胱移行细胞癌组织中的表达及其与临床病理的相关性.方法 应用免疫组织化学染色的方法,对163例手术证实的膀胱移行细胞癌患者的病理切片进行p53、VEGF、COX-2和EGFR的化学染色.将免疫组化结果与临床分期、病理分级进行相关性分析.结果 膀胱移行细胞癌组织中,p53、VEGF、EGFR的表达率与肿瘤临床分期显著相关(P<0.05),而与COX-2表达率无显著性差异(P>0.05),p53、EGFR的阳性表达强度随着肿瘤分期的升高而增强(P<0.05);p53的表达率及表达强度随着肿瘤病理分级的升高而增高,具有统计学意义(P<0.05),VEGF、COX-2、EGFR在不同病理分级膀胱移行细胞癌组织中的表达率无显著性差异(P>0.05);p53阳性表达强度和VEGF、COX-2、EGFR表达强度呈正相关(P<0.05),COX-2表达强度与VEGF、EGFR表达强度呈正相关(P<0.05);在不同临床分期的膀胱移行细胞癌(BTCC)组织中,p53和VEGF、VEGF和EGFR联合表达阳性率与单一指标阳性表达存在差异,有统计学意义(P<0.05).结论p53、VEGF、COX-2、EGFR的过度表达对BTCC的发生发展起着协同的作用,p53、VEGF、EFGR的联合检测更有助于膀胱移行细胞癌临床分期的判断.%Objective This study was designed to investigate the expressions of p53 , VEGF, COX-2 and EGFR in bladder cancer tissues , and to explore the relationship between the expressions and clinicopathological parameters in patients with blad -der cancer .Methods The expressions of p53, VEGF, COX-2 and EGFR in 163 cases of bladder cancer were assessed by im-munohistochemistry, and their correlations with clinicopathological factors were statistically analyzed . Results The expressions of p53 , VEGF and EGFR correlated with the clinical stage ( P<0. 05 ), but not with the expression of COX-2 ( P> 0. 05) . In addition , the expression intensity of p53 and EGFR increased with higher clinical stage (P<0. 05) . The expression rates and intensity of p53 were associated with pathologic grade (P<0. 05) . The expression intensity of p53 had a positive correlation with the expression intensity of VEGF , COX-2 and EGFR (P<0. 05), and the expression intensity of COX-2 had a positive correlation with the expression intensity of VEGF and EGFR (P<0. 05) . There was significant difference between single index expression (p53 , VEGF, EGFR) and co-expression (p53 combined with VEGF , VEGF combined with EGFR) in bladder transitional cell carcinoma of different clinical stages .Conclusions The abnormal expression of p53 , VEGF, COX-2 and EGFR might play a certain role in the course of the genesis and development of bladder transitional cell carcinoma . Combined detection of p53 , VEGF and EGFR may help to confirm the clinical stage of bladder transitional cell carcinoma .