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目的 探讨结直肠腺瘤中细胞凋亡和增殖与 bcl- 2和 P53蛋白表达的关系。方法 对 45例结直肠腺瘤用原位末端标记（ TUNEL）法检测细胞凋亡；以增殖细胞核抗原标记增殖指数检测其增殖活性；用免疫组织化学法检测 bcl- 2和 P53蛋白表达。另选结直肠高分化腺癌和正常黏膜各 10例作为对照检测。结果 45例结直肠腺瘤细胞的凋亡指数（ AI）为（ 90. 85± 0. 24）％，结直肠腺癌细胞的 AI为（ 1. 86± 0. 15）％，两者 AI均高于正常结直肠黏膜（ P<0.01）,而腺瘤与腺癌AI值差异也有显著性（P<0.05）；bcl-2和P53蛋白的表达率与细胞AI呈显著负相关（r_s=-0.65和r_s=-0.60），P53蛋白表达与细胞增殖活性呈正相关（r_s=0.86），而bcl-2蛋白表达与细胞增殖无相关性。结论 bcl-2和P53蛋白过度表达与细胞凋亡抑制、增殖失控关系密切，在结直肠腺瘤癌变进展中起一定作用。上述指标的联合检测可以作为临床早期判断结直肠腺瘤癌变的重要参考指标。
Objective To investigate the relationship between the apoptosis and proliferation of colorectal adenoma and the expression of bcl-2 and P53 protein. Methods 45 cases of colorectal adenomas were detected by TUNEL method. Proliferation index was detected by proliferation index of proliferating cell nuclear antigen (PCNA). The expressions of bcl-2 and P53 protein were detected by immunohistochemistry. Another selection of colorectal adenocarcinoma and normal mucosa of 10 cases as a control test. Results The AI of colorectal adenoma cells was (90.85 ± 0.24)% in 45 cases, and (1.86 ± 0.15)% in colorectal adenocarcinoma cells. Both AI (P <0.01), while there was also a significant difference in AI values between adenoma and adenocarcinoma (P <0.05). The expressions of bcl-2 and P53 proteins were negatively correlated with cell AI (r_s = - 0.65 and r_s = -0.60). P53 protein expression was positively correlated with cell proliferation (r_s = 0.86), while no correlation was found between bcl-2 protein expression and cell proliferation. Conclusion The overexpression of bcl-2 and p53 is closely related to the inhibition of apoptosis and the uncontrolled proliferation of colorectal adenoma, which play a role in the progression of colorectal adenoma. Joint detection of these indicators can be used as an early clinical judgment of colorectal adenoma cancerous important reference indicators.