CAJ | 학술논문

目的：探讨细胞周期与细胞凋亡相关蛋白p53、bcl－2、Ki－67和细胞凋亡在角化棘皮瘤（Keratoacanthoma，KA）和高分化鳞状细胞癌（Well－differentiated squamous cell carcinoma ，WDSCC）中的表达及其意义。方法应用免疫组化技术和末端特异性DNA标记技术检测44例角化棘皮瘤、20例高分化鳞状细胞癌标本中p53、bcl－2、Ki－67和细胞凋亡的表达情况。结果 KA增生期、成熟期和消退期p53阳性表达率分别为：22．23％、26．18％和6．52％，低于WDSCC 41．82％。 KA各期分别与WDSCC阳性率比较，差异有统计学意义；Ki－67的表达强度和模式同p53相似，p53表达率与Ki－67表达率呈正相关（ r＝0．986，P＜0．001）；KA中仅1例基底层见bcl－2弱阳性表达，WDSCC中2例表达呈弱阳性；KA的平均凋亡率（21．72％）明显高于WDSCC（9．93％），两者比较差异有统计学意义，细胞凋亡率与增殖率（Ki－67）的表达呈负相关（r＝－0．824，P＜0．001）。结论增生和凋亡同时存在于KA中，早期增生占优势，而消退期凋亡占优势，最终导致KA的自然消退。 p53、Ki－67以及细胞凋亡的表达对临床鉴别KA与WDSCC有一定参考价值。
목적：탐토세포주기여세포조망상관단백p53、bcl－2、Ki－67화세포조망재각화극피류（Keratoacanthoma，KA）화고분화린상세포암（Well－differentiated squamous cell carcinoma ，WDSCC）중적표체급기의의。방법응용면역조화기술화말단특이성DNA표기기술검측44례각화극피류、20례고분화린상세포암표본중p53、bcl－2、Ki－67화세포조망적표체정황。결과 KA증생기、성숙기화소퇴기p53양성표체솔분별위：22．23％、26．18％화6．52％，저우WDSCC 41．82％。 KA각기분별여WDSCC양성솔비교，차이유통계학의의；Ki－67적표체강도화모식동p53상사，p53표체솔여Ki－67표체솔정정상관（ r＝0．986，P＜0．001）；KA중부1례기저층견bcl－2약양성표체，WDSCC중2례표체정약양성；KA적평균조망솔（21．72％）명현고우WDSCC（9．93％），량자비교차이유통계학의의，세포조망솔여증식솔（Ki－67）적표체정부상관（r＝－0．824，P＜0．001）。결론증생화조망동시존재우KA중，조기증생점우세，이소퇴기조망점우세，최종도치KA적자연소퇴。 p53、Ki－67이급세포조망적표체대림상감별KA여WDSCC유일정삼고개치。
Objective To explore the expressions and significances of p 53、bcl-2、Ki-67 and apopto-sis in keratoacanthoma(KA)and well differentiated squamous cell carcinoma (WDSCC).Methods The expres-sions of p53、bcl-2、Ki-67 were detected by immunohistochemical technique in 44 cases of KA and 20 cases of WDSCC.Apoptosis was identified by using terminal deoxynucleotidyl transfers ( TdT) -mediated dUTP -biotin nick and labelling(TUNEL)method.Results The positive expressive rates of p53 in proliferative、mature and re-gressive of KA were 22.23%、26.18% and 6.52%, which was lower than the positive rate of WDSCC (41.82%).Significant differences were found between every period of KA with WDSCC in p 53 expression;The intensity of expression and pattern were similar in KA of Ki -67 and p53.There were a positive correlation be-tween p53 and Ki-67 expression rate(r=0.986,P<0.001).The bcl-2 staining showed weak expression in 1 case in WDSCC and 2 cases in KA ,but only a few positive tumor cells was limited to basal cell layer in KA .The average apoptosis rate in KA was 21.72%,which was apparently higher than in WDSCC (9.925%).There were a negative correlation between the apoptosis rate and proliferation rate of Ki -67(r=-0.824,P<0.001).Con-clusion The proliferation and apoptosis in KA can coexist .However ,the apoptosis will occupy a dominance posi-tion in regressive phase ,which results in the regression of tumor .The expressions of p53、Ki-67 and apoptosis would be a certain significance in differentiated KA and WDSCC .