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研究家族性腺癌性息肉病（FAP）癌变过程中P21－H－ras、EGFR和P53的变化与意义。方法：用ABC免疫组化方法检测并比较以上三种指标在41例FAP患者的正常肠粘膜、腺瘤和癌组织标本中表达情况。结果：P21－H－ras、EGFR及P53在正常肠粘膜中阳性表达率分别为0、4．7％与0，在腺癌中为29．3％、35．4％与20．8％，癌组织中为47．4％、60．6％与52．6％，癌与腺癌的阳性率都显著高于正常肠粘膜（P＜0．05）；P21－H－ras、EGFR在癌组织中的阳性率高于腺瘤，但差别不显著（P＞0．05），P53在癌的阳性率显著高于腺癌（P＜0．05）。癌组织有2个以上指标阳性者占55．6％，3个都阳性者占27．3％；腺瘤中分别为13．2％与4．4％，差别显著（P＜0．05）。结论：提示P21－H－ras、EGFR、P53基因都参与FAP癌变，P21－H－ras基因、EGFR可能作用于早期，P53基因则作用于晚期。检测P21－H－ras、EGFR、P53对早期诊断FAP癌变有一定意义。
To study the changes and significance of P21-H-ras, EGFR and P53 in familial adenocarcinoma polyposis (FAP) carcinogenesis. Methods: ABC immunohistochemical method was used to detect and compare the expression of the above three indicators in normal intestinal mucosa, adenoma and cancer tissue specimens of 41 patients with FAP. Results: The positive expression rates of P21-H-ras, EGFR and P53 in normal intestinal mucosa were 0, 4.7% and 0, respectively. In adenocarcinoma, 29.3%, 35.4% and 20.8%, respectively. Among the cancer tissues, 47.4%, 60.6%, and 52.6%, the positive rates of cancer and adenocarcinoma were significantly higher than those of normal intestinal mucosa (P<0.05); P21-H-ras, EGFR in cancer The positive rate in tissues was higher than that in adenomas, but the difference was not significant (P>0.05). The positive rate of P53 in cancer was significantly higher than that in adenocarcinoma (P<0.05). More than two cancer markers were positive in 55.6%, and all were positive in 27.3%; adenomas were 13.2% and 4.4%, respectively (P<0.05). . Conclusion: It is suggested that P21-H-ras, EGFR and P53 genes all participate in the carcinogenesis of FAP, P21-H-ras gene and EGFR may act early, and P53 gene may act late. Detection of P21-H-ras, EGFR, P53 is of significance in the early diagnosis of FAP cancer.