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目的探讨大肠粘膜癌变中细胞增殖和凋亡的特征以及凋亡相关调控基因的表达。方法对60例大肠腺瘤.癌用原位末端标记(TUNEL)法检测细胞凋亡,免疫组化SP法检测PCNA增殖指数(proliferativeindex,PI)及bcl-2和p53蛋白的表达。另选大肠高分化腺癌和正常粘膜20例作为对照检测。结果①正常粘膜、腺瘤和腺癌的p53蛋白表达率为5%、33.3%和70%。三组间有显著的差异(P均<0.05)。②正常粘膜、腺瘤和腺癌的bcl-2蛋白表达率分别为15%、70%和65%.腺瘤和腺癌组均高于正常对照组(P均<0.01),腺瘤与腺癌组间差异不显著(P均>0.05)。③大肠腺瘤和腺癌细胞的凋亡指数(AI)均高于正常粘膜(P均<0.01),bel-2和p53蛋白的表达率与细胞AI呈显著负相关(r_(?)=-0.66,r_(?)=-0.62)。结论凋亡和增殖在肿瘤的发生、发展、转化中起着重要作用,上述指标的联合检测可以作为临床早期判断人肠腺瘤癌变的重要参考指标。
Objective To investigate the characteristics of cell proliferation and apoptosis in colorectal carcinogenesis and the expression of apoptosis-related regulatory genes. Methods Tumor necrosis factor (Apoptosis) was detected by TUNEL in 60 cases of colorectal adenoma. The proliferative index (PCNA), the expression of bcl-2 and p53 were detected by immunohistochemistry. Another selection of colorectal adenocarcinoma and normal mucosa 20 cases as a control test. Results ① The expression rates of p53 protein in normal mucosa, adenoma and adenocarcinoma were 5%, 33.3% and 70%. There were significant differences among the three groups (all P <0.05). ② The rates of bcl-2 protein expression in normal mucosa, adenoma and adenocarcinoma were 15%, 70% and 65%, respectively. Both adenoma and adenocarcinoma were higher than those in normal control group (P <0.01) There was no significant difference between cancer groups (P> 0.05). The apoptosis index (AI) of colorectal adenoma and adenocarcinoma were higher than that of normal mucosa (all P <0.01). The expression rates of bel-2 and p53 were negatively correlated with cell AI (r _ (?) = 0.66, r _ (?) = - 0.62). Conclusions Apoptosis and proliferation play an important role in carcinogenesis, development and transformation of tumor. The combined detection of the above indexes can be used as an important reference index for early diagnosis of human intestinal adenoma.