【摘要】 目的 探讨p53、CK20、C-erbB-2在膀胱尿路上皮癌（BUC）中的表达和意义。方法 采用免疫组化二步法（EnVison）分别检测118例BUC、21例良性病变中的p53、CK20、C-erbB-2的表达。结果 118例尿路上皮癌中p53、CK20、C-erbB-2的阳性表达率分别为88.1%、26.3%和45.8%。尿路上皮癌的p53阳性率明显高于良性病变（χ2=13.55，P<0.01），低级别尿路上皮癌p53弱阳性率明显高于高级别（χ2=8.11， P<0.01），强阳性率明显低于高级别路上皮癌（χ2=9.53，P<0.01）；CK20在良性病变阳性率低于尿路上皮癌（χ2=5.67， P<0.05），低级别尿路上皮癌CK20阳性表达率明显低于高级别（χ2=22.17，P <0.01）；尿路上皮癌中C-erbB-2表达与良性病变具有显著性差异（χ2=13.85， P<0.01），低级别尿路上皮癌C-erbB-2强阳性率明显低于高级别组（χ2=7.91， P<0.01），低别级尿路上皮癌C-erbB-2表达往往较弱或浆阳性。结论p53、CK20和C-erbB-2在BUC中过表达，并在尿路上皮癌的诊断和鉴别诊断，以及分级中具有一定有临床意义。
[Abstract] Objective To study the expression and significance of p53, CK20 and C-erbB-2 in uroepithelium carcinoma of bladder(BUC). Methods The expression levels of p53, CK20 and C-erbB-2 in 118 cases of BUC and 21 cases of benign lesion were detected with immunohistochermical EnVision method. Results The positive expression rates of p53 was 88.1%,CK20 were 26.3%, and C-erbB-2 were 45.8% in 118 cases of BUC. The expression of p53 in BUC was significantly increased associated with the benign lesions(P<0.01). The weakly positivity rate of p53 in low grade group was significantly more strong than in high grade group (P<0.01), but the strong positivity rate was significantly more lower than in high grade group (P<0.01). The positivity rate of CK20 in the benign lesions was lower than BUC, and the positivity rate of CK20 in low grade group was significantly more lower than in high grade group (P<0.01). There was significantly difference in expression of C-erbB-2 in BUC and the benign lesion(P<0.01). The positive expression rates of C-erbB-2 was higher and more strong in high grade group than in low grade group (P<0.01). The positive expression in low grade group always was weak or located in kytoplasm. Conclusion The overexpression of p53, CK20 and C-erbB-2 protein was observed in BUC, and their positive expressions were correlated with tumor grade, diagnosis and differential diagnosis.
［Keywords］Bladdler neoplasmas; Immunohistochemistry; p53; cytokeratin20; C-erbB-2
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