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[目的]探讨术前动脉化疗对膀胱癌p53和增殖细胞核抗原(PCNA)表达的影响及临床意义。[方法]将50例膀胱癌患者在动脉化疗前后分别采集肿瘤标本,应用免疫组织化学SP法染色测定p53和PCNA的表达,并对化疗后膀胱癌组织进行电镜超微结构观察及5年生存率随访。[结果]动脉化疗后膀胱癌p53蛋白阳性表达率为18%(9/50),明显低于化疗前的46%(23/50),两者比较差异有显著性(P<0.01)。动脉化疗后膀胱癌PCNA标记指数为20(10/50),明显低于化疗前的38(19/50),两者比较差异有显著性(P<0.05)。电镜超微结构观察到动脉化疗后的癌细胞有明显受损改变;经随访行术前动脉化疗配合手术的患者,5年生存率为84%,5年复发率为21%。[结论]术前动脉化疗可以明显降低膀胱癌p53和PCNA表达,降低复发率,提高生存率。
[Objective] To investigate the effect and clinical significance of preoperative arterial chemotherapy on the expression of p53 and proliferating cell nuclear antigen (PCNA) in bladder cancer. [Methods] Tumor specimens were collected from 50 patients with bladder cancer before and after arterial chemotherapy. The expressions of p53 and PCNA were detected by immunohistochemical SP staining. The ultrastructure of bladder cancer after chemotherapy and the 5-year survival rate Follow-up. [Results] The positive rate of p53 protein in bladder cancer after arterial chemotherapy was 18% (9/50), which was significantly lower than that of 46% (23/50) before chemotherapy. The difference was significant (P <0.01). The PCNA labeling index of bladder cancer after arterial chemotherapy was 20 (10/50), which was significantly lower than that of 38 (19/50) before chemotherapy, the difference was significant (P <0.05). Electron microscopy showed significant changes in the cancerous cells after arterial chemotherapy. The 5-year survival rate was 84% and the 5-year recurrence rate was 21% after follow-up with preoperative arterial chemotherapy. [Conclusion] Preoperative arterial chemotherapy can significantly reduce the expression of p53 and PCNA in bladder cancer, reduce the recurrence rate and improve the survival rate.