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目的对细胞凋亡及其相关基因在乳腺癌预后中的作用，以及它们的表达水平与乳腺癌生物学行为的关系进行研究。方法运用ＴＵＮＥＬ法、免疫组化检测乳腺癌组织细胞凋亡水平以及凋亡相关基因ｂｃ１２、ｂａｘ、ｐ２７ｋｉｐｌ表达。结果９１例乳腺癌病例中，５６／９１（６１．５％）的病例凋亡指数较高，３５／９１（３８．５％）凋亡指数较低；ｂｃ１２高表达占２９．７％（２７／９１），ｂａｘ高表达占３０．８％（２８／９１）。１８１例乳腺癌中，ｐ２７ｋｉｐｌ高表达占３３．１％（６０／８１）。相关性分析发现，ｂｃ１２高表达，ＡＩ低的病例，组织学分级高，易出现腋淋巴结转移和术后复发；ｂａｘ、ｐ２７ｋｉｐｌ高表达者，组织学分级低，腋淋巴结转移及术后复发少。单因素生存分析显示，ＡＩ高，ｂａｘ、ｐ２７ｋｉｐｌ高表达，ｂｃ１２低表达的病例，术后无复发生存率、总生存率优于ＡＩ低，ｂａｘ、ｐ２７ｋｉｐｌ低表达，ｂｃ１２高表达者。ＣＯＸ模型多因素分析发现，ｂｃ１２、ｐ２７ｋｉｐｌ蛋白具有独立的预后价值；８４例淋巴结阴性乳腺癌中，ｐ２７ｋｉｐｌ表达有独立预后作用。结论凋亡相关基因ｂｃ１２、ｂａｘ、ｐ２７ｋｉｐｌ表达状态失控，使细胞凋亡过程失调，?
Objective To study the role of apoptosis and its related genes in the prognosis of breast cancer and their relationship with the biological behavior of breast cancer. Methods TUNEL method was used to detect the apoptosis of breast cancer cells and the expression of bcl-2, bax and p27kipl in breast cancer tissues by immunohistochemistry. Results Among the 91 cases of breast cancer, 56 of 91 (61.5%) had higher apoptosis index and 35/91 (38.5%) had lower apoptotic index. The bc1-2 overexpression accounted for 29.7% (27/91), bax high expression accounted for 30.8% (28/91). 181 cases of breast cancer, p27kipl high expression accounted for 33.1% (60/81). Correlation analysis found that bc1 2 high expression, low AI cases, histological grade, prone to axillary lymph node metastasis and recurrence; bax, p27kipl high expression, histological grade, axillary lymph node metastasis and recurrence less. Univariate survival analysis showed that AI high, bax, p27kipl high expression, low expression of bc1 2 cases, postoperative recurrence-free survival, overall survival rate is better than AI, bax, p27kipl low expression, bc1 2 high expression . COX model multivariate analysis found that bc1 2, p27kipl protein has an independent prognostic value; 84 cases of node-negative breast cancer, p27kipl expression has an independent prognostic role. Conclusion The expression of apoptosis-related genes bc1 2, bax, p27kipl out of control, so that the process of apoptosis was dysfunctional?