Lee C S, Pirdas A
University of Melbourne Department of Pathology, Victoria.
Pathology. 1995 Apr;27(2):117-20. doi: 10.1080/00313029500169692.
Immunohistochemical expression of the p53 protein was investigated in carcinoma of the gallbladder (n = 13), common bile duct (n = 7) and ampulla of Vater (n = 9) using the polyclonal, CM1, and monoclonal, DO7, antibodies (Novocastra). This was compared with cases of chronic cholecystitis (n = 11) and preneoplastic lesions of the gallbladder (n = 4) and ampulla (n = 3). Nuclear immunostaining for p53 protein was found only in the poorly differentiated adenocarcinomas of the gallbladder (n = 9) and were associated with a shorter patient survival period (median: 18.6 mths). The moderately differentiated adenocarcinomas (n = 4) did not show p53 immunostaining and were associated with a longer median survival period (26 mths). The gallbladder dysplasias and adenoma also had no p53 protein immunoreactivity. The common bile duct carcinomas did not stain for p53. Focal p53 immunoreactivity was present in only one (11%) of the cases of ampullary carcinoma and in one (9%) of chronic cholecystitis. In summary, increased p53 immunostaining was associated with reduced patient survival and found more frequently in poorly differentiated adenocarcinoma of the gallbladder but not in the better differentiated carcinoma, chronic cholecystitis or preneoplastic lesions of the gallbladder. The differences in p53 immunohistological expression between gallbladder, common bile duct and ampullary carcinomas justify further investigation into the molecular mechanisms responsible for their development.
采用多克隆抗体CM1和单克隆抗体DO7（诺沃卡斯托公司），对13例胆囊癌、7例胆总管癌和9例壶腹癌进行p53蛋白的免疫组化表达研究。并与11例慢性胆囊炎、4例胆囊癌前病变及3例壶腹癌前病变病例进行比较。仅在9例低分化胆囊腺癌中发现p53蛋白的核免疫染色，且与患者生存期较短相关（中位数：18.6个月）。4例中分化腺癌未显示p53免疫染色，且与较长的中位生存期相关（26个月）。胆囊发育异常和腺瘤也无p53蛋白免疫反应性。胆总管癌未检测到p53染色。仅1例（11%）壶腹癌和1例（9%）慢性胆囊炎存在局灶性p53免疫反应性。总之，p53免疫染色增加与患者生存期缩短相关，且在低分化胆囊腺癌中更常见，而在高分化癌、慢性胆囊炎或胆囊癌前病变中则未发现。胆囊癌、胆总管癌和壶腹癌之间p53免疫组化表达的差异，为进一步研究其发生发展的分子机制提供了依据。
