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目的:探讨突变型P53及bcl-2在维吾尔族外阴癌发生发展中的表达及其相互关系。方法:应用免疫组化SP法对67例维吾尔族妇女外阴手术切除存档蜡块(其中外阴癌57例,正常外阴组织10例为对照组、来自于外阴癌手术阴性切缘)进行突变型P53及bcl-2蛋白的检测。结果:(1)P53及bcl-2蛋白阳性表达率分别为52.63%(30/57)及70.18%(40/57),而两者在10例癌旁组织中表达均阴性。(2)40例bcl-2蛋白阳性的外阴癌组织中有21例突变型P53阳性(52.50%),17例bcl-2阴性的外阴癌组织中有9例突变型P53阳性(52.94%),突变型P53及bcl-2蛋白之间无直线相关关系(r~2=-0.04,P=0.976)。(3)突变型P53在Ⅰ期、Ⅱ期及Ⅲ～Ⅳ期外阴癌中表达率分别为74.4%、45.0%及70.0%,其表达在各期别之间无显著性差异(P=2.395);bcl-2在Ⅰ期、Ⅱ期及Ⅲ～Ⅳ期外阴癌中表达率分别为70.18%,75.0%及50.0%,其在各期别之间无显著性差异(P=0.302)。突变型P53及bcl-2在外阴癌高,中及低分化组织中的表达无显著性差异(P=0.474、0.215),bcl-2在外阴鳞癌淋巴结阳性组明显高于淋巴结阴性组,两者之间有显著性差异(P=0.044),而突变型P53在外阴鳞癌淋巴结阳性组和淋巴结阴性组之间差异无显著性(P=0.512)。结论:(1)突变型P53、bcl-2的表达与维吾尔族外阴癌的发生密切相关,可能为外阴癌发生、发展中的相对独立因素。(2)P53突变型和bcl-2的表达可能与外阴癌临床分期及组织学分级无明显相关,bcl-2阳性表达与淋巴结转移有关,而突变型P53阳性表达与淋巴结转移无关。
Objective: To investigate the expression of Mutant P53 and bcl-2 in the development and progression of vulvar cancer in Uighur and their relationship. Methods: Immunohistochemical SP method was used to detect the mutation of P53 (P53) in 67 cases of Uygur vulvae (including 57 cases of vulvar cancer and 10 cases of normal vulvar tissue as the control group) bcl-2 protein detection. Results: (1) The positive expression rates of P53 and bcl-2 protein were 52.63% (30/57) and 70.18% (40/57) respectively, but both of them were negative in 10 paracancerous tissues. (2) Of the 40 specimens of vulvar cancer with bcl-2 protein positive, 21 were positive for mutant p53 (52.50%), 9 were positive for mutant p53 (52.94%) in 17 of 17 specimens of bcl-2 negative vulvar cancer, There was no linear correlation between mutant P53 and bcl-2 protein (r ~ 2 = -0.04, P = 0.976). (3) The expression of mutant P53 was 74.4%, 45.0% and 70.0% in stage Ⅰ, Ⅱ, and Ⅲ ~ Ⅳ vulvar cancer respectively. There was no significant difference between the two groups (P = 2.395) The expression rates of bcl-2 in stage Ⅰ, stage Ⅱ and stage Ⅲ ~ Ⅳ vulvar cancer were 70.18%, 75.0% and 50.0%, respectively. There was no significant difference between the two groups (P = 0.302). There was no significant difference in the expression of mutant p53 and bcl-2 in high, moderate and poorly differentiated vulvar cancers (P = 0.474,0.215). The positive rate of bcl-2 in lymph node-positive patients with vulvar squamous cell carcinoma was significantly higher than that in lymph node-negative patients (P = 0.044). However, there was no significant difference in the expression of mutant P53 between VSCC positive lymph node group and lymph node negative group (P = 0.512). Conclusions: (1) The expression of mutant p53 and bcl-2 is closely related to the occurrence of vulvar cancer in Uighur, which may be the relative independent factor in the occurrence and development of vulvar cancer. (2) The expression of P53 mutant and bcl-2 may not be related to the clinical stage and histological grade of vulvar cancer. The positive expression of bcl-2 is related to the lymph node metastasis, while the positive expression of mutant p53 is not related to lymph node metastasis.