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目的 :探讨凋亡相关基因bcl 2和bax在人肺癌组织中的表达情况及其与肺癌的各种临床病理特征和预后的关系。方法 :用免疫组织化学SABC法检测经手术治疗的72例肺癌患者的病理标本 ,用TUNEL法检测其中的细胞调亡情况 ,其中小细胞未分化癌4例 ,鳞癌38例 ,腺癌30例 ,同时检测11例正常肺组织作为对照。结果 :在肺癌组织中bcl 2蛋白的阳性表达率为37.50% ,bax的阳性表达率则为51.39% ,两者与正常肺组织比较均存在显著性差异(P<0.05/0.01) ;bcl 2在小细胞未分化癌中的阳性表达率为100.00%(4/4) ,高于非小细胞肺癌的33.82%(P<0.05) ;bcl 2在鳞癌的阳性表达率为50.00 % ,高于腺癌的13.33 %(P<0.05) ;bax在鳞癌中的阳性表达率为39.47 % ,小于腺癌的73.33%(P<0.05)。分析两基因在非小细胞肺癌中的阳性表达情况 ,bcl 2/bax>1者在高分化癌中占50.00% ,大于中、低分化癌及未分化癌的17.86 %(P<0.05) ;在Ⅰ期肺癌中占39.13 % ,高于Ⅱ Ⅲ期肺癌的15.56%(P<0.05) ;在生存时间大于3年的肺癌中占40.00 % ,高于生存时间小于3年的肺癌的13.90 %(P<0.05)。bcl 2/bax<1者在生存时间大于3年的肺癌中占20.00% ,低于生存时间小于3年的肺癌的51.16%(P<0.05)。肺癌组织的调亡指数(AI)为1.83±0.52,小于正常肺组织的14.33±5.62(P<0.0
Objective: To investigate the expression of apoptosis-related genes bcl 2 and bax in human lung cancer tissues and their relationship with various clinicopathological features and prognosis of lung cancer. METHODS: The pathological specimens of 72 lung cancer patients undergoing surgery were detected by immunohistochemical SABC method. The apoptotic cells were detected by TUNEL method. Among them, 4 cases of small cell undifferentiated carcinoma, 38 cases of squamous cell carcinoma, and 30 cases of adenocarcinoma. At the same time, 11 normal lung tissues were detected as controls. Results: The positive expression rate of bcl 2 protein was 37.50% in lung cancer tissues, and the positive rate of bax was 51.39%. There was significant difference between the two groups and normal lung tissues (P<0.05/0.01); The positive rate of small cell undifferentiated carcinoma was 100.00% (4/4), which was higher than that of non-small cell lung cancer (33.82%, P<0.05). The positive rate of bcl 2 expression in squamous cell carcinoma was 50.00%, higher than that of the gland. 13.33% of cancers (P<0.05); the positive expression rate of bax in squamous cell carcinoma was 39.47%, which was lower than that of adenocarcinoma (73.33%) (P<0.05). The positive expression of the two genes in non-small cell lung cancer was analyzed. bcl 2/bax>1 accounted for 50.00% in well-differentiated carcinomas, and was 17.88% greater than those in poorly differentiated and differentiated carcinomas (P<0.05); Lung cancer accounted for 39.13% of stage I lung cancer, which was 15.56% higher than that of stage III lung cancer (P<0.05). It accounted for 40.00% of lung cancers that survived for more than 3 years and 13.9% of lung cancers whose survival time was less than 3 years (P <0.05). Those with bcl 2/bax <1 accounted for 20.00% of lung cancer patients whose survival time was greater than 3 years, and 51.16% less than those with lung cancer whose survival time was less than 3 years (P < 0.05). The apoptotic index (AI) of lung cancer was 1.83±0.52, which was smaller than that of normal lung tissue (14.33±5.62) (P<0.0).