Wee A, Teh M, Raju G C
Department of Pathology, National University Hospital, National University of Singapore.
J Clin Pathol. 1994 May;47(5):453-6. doi: 10.1136/jcp.47.5.453.
To study the expression and importance (if any) of p53 protein in gall bladder carcinoma and its precursor lesions.
Immunohistochemical staining was performed on formalin fixed, paraffin wax embedded histological sections with an anti-human p53 monoclonal antibody (DO-7; Dako Corporation M7001) (24 carcinomas, one adenocarcinoma in situ, six dysplasias, three adenomas and four cases of chronic cholecystitis). Invasive, in situ, and dysplastic areas as well as normal-looking epithelium were sought. Nuclear staining was assessed according to intensity and extent of positive cells. Both variables were graded on a scale of 1-3 and aggregate p53 scores were obtained (range: 0, 2-6). Only p53 scores of > or = 3 were regarded as significant.
Clinically important amounts of p53 were expressed in 92% of invasive carcinomas, 86% of carcinoma in situ, and 28% of dysplastic areas. None of the adenomas contained clinically important amounts of p53. Normal epithelium, present in all the cases, did not express p53 except in one case of moderately differentiated adenocarcinoma (p53 score 3). In general, there was no difference in the prevalence of p53 protein expression between dysplasias associated with, and those unassociated with invasive disease. There was a tendency for higher grade carcinomas to express more p53 protein.
The distribution of p53 protein in invasive carcinomas and the adjacent dysplastic and preinvasive lesions suggests that it is more commonly expressed than previously thought. The fact that p53 protein is also expressed in cases of dysplasia and carcinoma in situ unassociated with invasive malignancy lends further support to the contention that p53 gene mutations may have a role in the pathogenesis of gall bladder cancer. Expression of p53 protein may possibly be an indication of likely disease progression from dysplasia, to carcinoma in situ, to invasive disease.
研究p53蛋白在胆囊癌及其癌前病变中的表达情况及其重要性（若有）。
用抗人p53单克隆抗体（DO-7；达科公司M7001）对福尔马林固定、石蜡包埋的组织切片进行免疫组化染色（24例癌、1例原位腺癌、6例发育异常、3例腺瘤和4例慢性胆囊炎）。寻找浸润区、原位区、发育异常区以及外观正常的上皮组织。根据阳性细胞的强度和范围评估核染色情况。两个变量均按1-3级评分，并获得p53总分（范围：0、2-6）。仅p53评分≥3被视为有意义。
92%的浸润性癌、86%的原位癌和28%的发育异常区表达了具有临床意义的p53量。所有腺瘤均未表达具有临床意义的p53量。所有病例中均存在的正常上皮组织，除1例中分化腺癌（p53评分为3）外，均未表达p53。一般来说，与浸润性疾病相关和不相关的发育异常之间p53蛋白表达的患病率没有差异。高级别癌有表达更多p53蛋白的趋势。
p53蛋白在浸润性癌及相邻发育异常和癌前病变中的分布表明其表达比以前认为的更常见。p53蛋白在与浸润性恶性肿瘤无关的发育异常和原位癌病例中也有表达，这一事实进一步支持了p53基因突变可能在胆囊癌发病机制中起作用的观点。p53蛋白的表达可能是疾病从发育异常进展为原位癌再进展为浸润性疾病的一个指标。
