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目的：对各类肾上腺肿瘤的Ｐ５３基因作对比性实验研究，以探索其各自的发病机理，并试图以临床检测Ｐ５３蛋白表达及点突变作鉴别诊断。方法：３４例肾上腺恶性肿瘤及２５例良性瘤的病理标本行Ｐ５３蛋白表达，ＳＰ法ＤＡＢ显色见异常细胞颗粒者为阳性。ＰＣＲ－ＳＳＣＰ技术对５～９外显子作观测，显示一带或多带异常型者为阳性。两者结合分析，并与１２份肾上腺非瘤组织对照。结果：恶性瘤的Ｐ５３蛋白表达及点突变率分别为４７％及２９％阳性，而良性瘤为８％及４％，对照组为０％。浸润转移癌阳性率显著增高。恶性嗜铬细胞瘤的阳性率高达约７０％＋及６０％－。ＳＰ、ＰＣＲ合并阳性率＞单项阳性率。结论：各类肾上腺癌的发病与Ｐ５３基因突变相关联。恶性嗜铬细胞瘤阳性率高于皮质癌。浸润转移癌阳性率最高。Ｐ５３基因突变与有无皮、髓质激素分泌无关。
OBJECTIVE: To compare P53 gene expression in various types of adrenal tumors in order to explore their respective pathogenesis and to try to use clinical detection of P53 protein expression and point mutation for differential diagnosis. Methods: The pathological specimens of 34 adrenal malignant tumors and 25 benign tumors were performed with P53 protein expression. SP method DAB staining was positive for abnormal cell granules. The PCR-SSCP technique was used to observe 5-9 exons, showing that one or more abnormal bands were positive. The two were analyzed and compared with 12 non-neoplastic adrenal tissues. RESULTS: The P53 protein expression and point mutation rates of malignant tumors were 47% and 29%, respectively, whereas benign tumors were 8% and 4%, and the control group was 0%. The positive rate of invasive metastatic cancer was significantly higher. The positive rate of malignant pheochromocytoma is as high as about 70%+ and 60%-. Positive rate of SP and PCR mergers> single positive rate. Conclusion: The incidence of various types of adrenocortical carcinoma is associated with mutations in the P53 gene. The positive rate of malignant pheochromocytoma was higher than that of cortical carcinoma. Invasive metastatic carcinoma has the highest positive rate. P53 mutations have nothing to do with the presence of cutaneous or medullary hormone secretion.