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[目的]探讨Bcl_2和Bax在非小细胞肺癌及正常肺组织中的表达和相互关系及其意义。[方法]选取大连市第五人民医院1999年～2001年36例非小细胞肺癌患者术后的石蜡包埋标本。另选大连医科大学CRC(中日病理中心 )尸检的正常肺组织 ,应用免疫组织化学的方法 (SP法 )分别检测Bcl_2和Bax蛋白在非小细胞肺癌和正常肺组织中表达的情况。[结果]Bcl_2在非小细胞肺癌和正常肺组织中的表达阳性率分别为61%和25% ,Bax在两者中的表达分别为33%和67 % ,两者均有显著性差异。Bcl_2蛋白表达随分化程度降低而降低 ,随分期增高而下降。而Bax蛋白阳性率随分化程度降低而升高 ,随分期增高而增高 ,Bcl_2和Bax与非小细胞肺癌患者的细胞学类型、肿瘤大小、淋巴结转移等均无显著相关。在非小细胞肺癌中 ,两者表达呈显著负相关 (P<0.05)。[结论]在非小细胞肺癌中Bcl_2过度表达与肿瘤的分化程度、pT NM分期有关 ,而与细胞学类型、肿瘤大小和淋巴结转移无关。Bax与上述临床因素均无明显相关。但两者表达呈显著的负相关。Bcl_2过度表达可抑制细胞凋亡 ,Bax可提高凋亡的敏感性 ,两者的比率决定了在凋亡刺激下细胞是否进入凋亡。
[Objective] To explore the expression and relationship of Bcl_2 and Bax in non-small cell lung cancer and normal lung tissues and their significance. [Methods] Paraffin-embedded specimens of 36 patients with NSCLC from the Fifth People’s Hospital of Dalian City from 1999 to 2001 were selected. The normal lung tissue autopsied at the CRC (China-Japan Pathology Center) of Dalian Medical University was selected and immunohistochemistry (SP method) was used to detect the expression of Bcl-2 and Bax in non-small cell lung cancer and normal lung tissues, respectively. [Results] The positive expression rates of Bcl_2 in non-small cell lung cancer and normal lung tissues were 61% and 25%, respectively. The expression of Bax in the two groups was 33% and 67% respectively. There was a significant difference between the two groups. The expression of Bcl_2 protein decreased with the degree of differentiation, and decreased with the increase of stage. The positive rate of Bax protein increased with the degree of differentiation, and increased with the increase of the stage. Bcl_2 and Bax had no significant correlation with the cytological type, tumor size, and lymph node metastasis of NSCLC patients. In non-small cell lung cancer, there was a significant negative correlation between the two expressions (P<0.05). [Conclusion] The over-expression of Bcl-2 in NSCLC is related to the degree of tumor differentiation and pT NM stage, but not to the cytological type, tumor size and lymph node metastasis. Bax was not significantly associated with the above clinical factors. However, there was a significant negative correlation between the two expressions. Overexpression of Bcl_2 inhibits apoptosis, while Bax increases apoptosis sensitivity, and the ratio of the two determines whether the cell enters apoptosis when stimulated by apoptosis.