超声引导下肝穿刺物P53、MMP2的表达在肝癌的诊断、治疗及判断预后中的价值
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摘要
目的：通过对超声引导下肝肿物穿刺活检术所获得的组织经病理证实为肝细胞肝癌(HCC),并检测其P53、MMP2基因蛋白的表达水平,同时与手术切除的经病理证实为肝细胞肝癌组织的P53、MMP2蛋白的表达水平进行比较,研究超声引导下肝肿物穿刺术对肝癌诊断、治疗及判断预后的价值。
方法：经超声引导下肝肿物穿刺所得的组织经病理证实为肝细胞癌19例作实验组,取本院肝胆外科手术切除的组织经病理证实为肝细胞癌40例作对照组,用免疫组化方法检测两组标本P53、MMP2蛋白的表达水平。
结果：实验组P53阳性表达率为84.2%,对照组P53阳性表达率为87.5%,两组表达水平比较,差异没有统计学意义(P>0.05)；实验组MMP2阳性表达率为89.5%,对照组MMP2阳性表达率为85%,两组表达水平比较,差异没有统计学意义(P>0.05),并且无论实验组还是对照组,肿瘤组织中P53、MMP2蛋白的表达均密切相关,同时P53、MMP2蛋白的表达水平与肿块大小无关(P>0.05),与有无癌栓密切相关(P<0.05)。
结论：超声引导下肝肿物穿刺活检并检测肿瘤组织中P53、MMP2基因蛋白的表达水平对肝癌的诊断、治疗及判断预后具有重要价值。
Objectives:By the pathologic diagnosis of hepatocellular carcinoma(HCC) tissue which were obtained from ultrasound-guided needle biopsy, and detect their expression level of P53 and MMP2 gene proteins, simultaneasly contrasted with the HCC tissue which were obtained from operation, to explore the clinical application value of ultrasound-guided needle biopsy to liver tumor's diagnosis, therapy and the judgment of prognosis.
Method:19 cases tissue of hepatocellular carcinoma which were acquired from ultrasound-guided needle biopsy were enrolled experimental group, on the other hand,40 cases tissue of hepatocellular carcinoma which were acquired from operation in Hepatobiliary Surgery were enrolled control group, immunohistochemical technique was adopted to detect the protein expression level of P53、MMP2 gene.
Results:P53 positive expression rate of the experimental group was 84.2%, the control group was 87.5%, contrasted the expression levels of the two groups, the difference was not statistically significant (P> 0.05); MMP2 positive expression rate of the experimental group was 89.5%, the control group was 85%, contrasted the expression levels of the two groups, the difference was not statistically significant (P>0.05), and regardless of the experimental group or control group, the P53、MMP2 protein expression of tumor tissue were closely related to each other, at the same time P53、MMP2 protein expression level has nothing to do with tumor size (P>0.05), but was closely related with the tumor thrombus (P<0.05).
Conclusions:Ultrasound-guided liver tumor biopsy and detect the P53, MMP2 protein expression level of tumor tissue have great value to the liver cancer diagnosis, treatment and prognosis.
方法：经超声引导下肝肿物穿刺所得的组织经病理证实为肝细胞癌19例作实验组,取本院肝胆外科手术切除的组织经病理证实为肝细胞癌40例作对照组,用免疫组化方法检测两组标本P53、MMP2蛋白的表达水平。
结果：实验组P53阳性表达率为84.2%,对照组P53阳性表达率为87.5%,两组表达水平比较,差异没有统计学意义(P>0.05)；实验组MMP2阳性表达率为89.5%,对照组MMP2阳性表达率为85%,两组表达水平比较,差异没有统计学意义(P>0.05),并且无论实验组还是对照组,肿瘤组织中P53、MMP2蛋白的表达均密切相关,同时P53、MMP2蛋白的表达水平与肿块大小无关(P>0.05),与有无癌栓密切相关(P<0.05)。
结论：超声引导下肝肿物穿刺活检并检测肿瘤组织中P53、MMP2基因蛋白的表达水平对肝癌的诊断、治疗及判断预后具有重要价值。
Objectives:By the pathologic diagnosis of hepatocellular carcinoma(HCC) tissue which were obtained from ultrasound-guided needle biopsy, and detect their expression level of P53 and MMP2 gene proteins, simultaneasly contrasted with the HCC tissue which were obtained from operation, to explore the clinical application value of ultrasound-guided needle biopsy to liver tumor's diagnosis, therapy and the judgment of prognosis.
Method:19 cases tissue of hepatocellular carcinoma which were acquired from ultrasound-guided needle biopsy were enrolled experimental group, on the other hand,40 cases tissue of hepatocellular carcinoma which were acquired from operation in Hepatobiliary Surgery were enrolled control group, immunohistochemical technique was adopted to detect the protein expression level of P53、MMP2 gene.
Results:P53 positive expression rate of the experimental group was 84.2%, the control group was 87.5%, contrasted the expression levels of the two groups, the difference was not statistically significant (P> 0.05); MMP2 positive expression rate of the experimental group was 89.5%, the control group was 85%, contrasted the expression levels of the two groups, the difference was not statistically significant (P>0.05), and regardless of the experimental group or control group, the P53、MMP2 protein expression of tumor tissue were closely related to each other, at the same time P53、MMP2 protein expression level has nothing to do with tumor size (P>0.05), but was closely related with the tumor thrombus (P<0.05).
Conclusions:Ultrasound-guided liver tumor biopsy and detect the P53, MMP2 protein expression level of tumor tissue have great value to the liver cancer diagnosis, treatment and prognosis.
引文
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[3]吴晓莉,于德江,梁萍,等.恶性淋巴瘤的声像图特征及超声引导下穿刺活检术的价值[J].中国超声医学杂志,2002,18(11)：824—827。
[4]Lencioni L, Caramella D, Bartolozzi, etal.Percuand ous biopsy of liver tumors With Color Doppler US guidance. Abdominal Imaging, 1995,20:206—208.
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[7]李德树,夏承秉,何惠珠,李志艳.超声引导下经皮穿刺各部位器官占位性病变诊断与治疗的应用价值[J].中国超声医学杂志,1999,15(10)：784-786.
[8]王勇,杨德民,王毅,杨裕辉.彩色多普勒超声引导下肝脏组织自动活检枪穿刺术[J].兵团医学,2007,13(3)：44-45.
[9]王艳苓,张红红,王秀燕.超声引导下经皮肝脏穿刺活检的临床价值[J]. 实用肝脏病杂志,2009,12(1)：52-54.
[10]潘运龙,覃莉,蒋光,严林,王华曦.MDM2和P53蛋白表达与原发性肝细胞肝癌发生的关系[J].中国病理生理杂志,2004,20(1)：72-75。
[11]QUAN ZW, WU K。WANG J, et al. Association of p53, p16, and Vascular Endothelial Growth Factor Protein Expressions with the Prognosis and Metastasis of Gallbladder Cancer[J]. J Am Coll Surg,2001.193: 380—383.
[12]方燕,黄必军,梁启万.原发性肝癌p53基因高频缺失的双色莹光原位杂交证据[J].中国病理生理杂志,2003,19(3)：306—309.
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