目的：检测P53和mTOR在翼状胬肉组织和健康结膜组织中的表达，探讨P53和mTOR表达之间的关系，以及P53和mTOR的表达与翼状胬肉重要临床特征之间的关系。

方法：收集2022-11/2023-05在石河子大学第一附属医院眼科行翼状胬肉切除术+自体结膜移植术的患者的手术标本，共43例43眼。选取13例患者取健康结膜组织作为健康结膜组，健康结膜组织来源于患眼颞侧结膜。选取10例翼状胬肉标本、6例健康结膜标本，采用qPCR检测P53和mTOR在翼状胬肉和健康结膜组织中的mRNA表达水平； 选取33例翼状胬肉标本、7例健康结膜标本，采用免疫组织化学法检测P53和mTOR蛋白在翼状胬肉组织和健康结膜组织中的表达水平，使用IPP6.0软件统计平均光密度值，分析P53和mTOR表达之间的相关性，以及P53和mTOR与翼状胬肉的重要临床特征之间的相关性。

结果：根据qPCR结果，翼状胬肉组中P53和mTOR的mRNA表达水平相较于健康结膜组显著增强(均P<0.05)。根据免疫组织化学染色结果，P53和mTOR蛋白在翼状胬肉组中的表达水平相较于健康结膜组显著升高(P<0.05)。P53的表达量与mTOR的表达量呈正相关(r=0.417，P<0.05)。P53在户外活动时间>3 h组的表达量高于户外活动时间≤3 h组(P<0.05)，在翼状胬肉头端侵入角膜缘距离>2 mm组的表达量高于翼状胬肉头端侵入角膜缘距离≤2 mm组(P<0.05)，在>40岁和≤40岁两组翼状胬肉患者中无差异性表达(P>0.05)。mTOR的表达量在户外活动时间>3 h和≤3 h组、翼状胬肉头端侵入角膜缘距离>2 mm和≤2 mm组以及>40岁和≤40岁组中无差异(均P>0.05)。P53的表达量与患者的户外活动时长(r=0.484，P<0.01)、侵入角膜缘距离(r=0.479，P<0.01)呈正相关。mTOR的表达量与年龄、户外活动时间、侵入角膜缘距离无相关性(均P>0.05)。

结论：P53和mTOR在翼状胬肉中过度表达且呈正相关，提示在翼状胬肉的发病过程中P53和mTOR的异常表达可能起到一定促进作用，为进一步探究翼状胬肉的发病机制提供实验依据； P53的表达量与户外活动时间、翼状胬肉头端侵入角膜缘距离呈正相关，提示P53与翼状胬肉的发生发展相关，为翼状胬肉的临床诊断和治疗提供新思路。

METHODS: The surgical specimens of 43 patients(43 eyes)who underwent pterygium excision and autologous conjunctival transplantation in the First Affiliated Hospital of Shihezi University from November 2022 to May 2023 were collected. Healthy conjunctiva group was selected from the healthy conjunctival tissue that originated from the temporal conjunctiva of 13 patients. Totally 10 pterygium specimens and 6 normal conjunctival specimens were selected and the qPCR was used to detect the mRNA expression levels of P53 and mTOR in pterygium and normal conjunctival tissues. Another 33 cases of pterygium and 7 cases of normal conjunctival tissues were collected and the expression of P53 and mTOR in pterygium and normal conjunctival tissues were detected by immunohistochemistry. IPP6.0 software was used to calculate the average optical density, the correlation between the expression levels of P53 and mTOR, and the correlation between the expression levels of P53 and mTOR and the important clinical features of pterygium were analyzed.

RESULTS: According to qPCR results, the mRNA expression levels of TP53 and mTOR in the pterygium group were significantly higher than those in the healthy conjunctiva group(all P<0.05). According to the immunohistochemical staining results, the expression levels of P53 and mTOR proteins in the pterygium group were significantly higher than those in the healthy conjunctiva group(P<0.05). The expression of P53 was positively correlated with the expression of mTOR(r=0.417, P<0.05). The expression of P53 in the group of outdoor activity time > 3 h was higher than that in the group of outdoor activity time ≤3 h(P<0.05). The expression of P53 in the group of pterygium head invasive limbal distance > 2 mm was higher than that in the group of pterygium head invasive limbal distance ≤2 mm(P<0.05). There was no difference in the expression of pterygium between the two groups of patients aged > 40 years and ≤40 years(P>0.05). There was no significant difference in the expression of mTOR between the groups of outdoor activity time > 3 h and ≤3 h, the group of pterygium head invasion distance > 2 mm and ≤2 mm, and the group of > 40 years old and ≤40 years old(all P>0.05). The expression of P53 was positively correlated with the duration of outdoor activities(r=0.484, P<0.01)and the distance of limbal invasion(r=0.479, P<0.01). The expression of mTOR was not correlated with age, duration of outdoor activities, and distance of limbus invasion(all P>0.05).

CONCLUSION: The overexpression of P53 and mTOR in pterygium showed a positive correlation, suggesting that the abnormal expression of P53 and mTOR may play a role in the pathogenesis of pterygium, which provides an experimental basis for further exploring the pathogenesis of pterygium; the expression of P53 is positively correlated with the time of outdoor activities and the distance of pterygium invasion. The P53 plays a role in evaluating the severity of pterygium, and provides new ideas for the clinical diagnosis and treatment of pterygium.