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目的 :通过观察乳腺癌及其癌前病变中细胞凋亡和凋亡调控基因 p5 3、bcl- 2的表达 ,探讨细胞凋亡与凋亡调控基因在乳腺组织恶性转化进程中的作用。方法 :利用DNA缺口末端标记技术和免疫组织化学染色 ,原位观察 31例乳腺癌 ,2 0例乳腺不典型增生和 2 0例乳腺单纯性增生中细胞凋亡和p5 3、bcl- 2蛋白的表达 ,以 8例正常乳腺组织作为对照。结果 :乳腺不典型增生和单纯性增生中细胞凋亡指数显著高于乳腺癌及正常乳腺组织 (P <0 0 1) ,乳腺癌中细胞凋亡指数高于正常乳腺组织 (P <0 0 5 )。乳腺癌和乳腺不典型增生中 p5 3蛋白阳性率分别高于正常乳腺组织 (P <0 0 5 )。凋亡细胞多分布在 p5 3、bcl- 2蛋白阴性区 ,阳性区仅有少量分布 ,且 p5 3、bcl- 2蛋白阴性组细胞凋亡指数高于阳性组 (P <0 0 5 )。结论 :细胞凋亡调控失调在乳腺组织恶性转化进程中起重要的作用。突变型p5 3、bcl- 2蛋白可抑制细胞凋亡。
Objective : To investigate the role of apoptosis and apoptosis-regulating genes in the malignant transformation of mammary glands by observing the expression of apoptosis and apoptosis-regulating genes p53 and bcl-2 in breast cancer and its precancerous lesions. METHODS: Apoptosis and p53, bcl-2 protein were detected in situ in 31 cases of breast cancer, 20 cases of atypical hyperplasia of the breast, and 20 cases of simple hyperplasia of the breast using DNA nick end labeling and immunohistochemical staining. For expression, 8 normal breast tissues were used as controls. Results: The apoptotic index in breast atypical hyperplasia and simple hyperplasia was significantly higher than that in breast cancer and normal breast tissue (P <0 01). The apoptotic index in breast cancer was higher than that in normal breast tissue (P <0 0 5. ). The positive rate of p53 protein in breast and breast atypical hyperplasia was higher than that in normal breast tissue (P < 0.05). The apoptotic cells were mostly distributed in the p53 and bcl-2 negative regions, and the positive regions were only slightly distributed. The apoptotic index in the p53 and bcl-2 negative group was higher than that in the positive group (P < 0.05). Conclusion : Disregulation of apoptosis regulation plays an important role in malignant transformation of breast tissue. Mutant p53 and bcl-2 proteins inhibit apoptosis.