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目的：通过对细胞凋亡及部分相关蛋白的表达进行检测，探讨子宫颈鳞状细胞癌组织中凋亡细胞的调控机制。方法：应用原位末端标记法（ＴＵＮＥＬ）和双重免疫荧光染色技术对正常子宫颈及不同分化程度的鳞状细胞癌组织中凋亡细胞和Ｂａｘ、Ｂｃｌ－ ２、ｃａｓｐａｓｅ－３蛋白表达进行检测，利用共聚焦显微镜观察结果。结果：ＴＵＮＥＬ法检测发现，每例标本均有不同程度的细胞凋亡，但数量及分布区域不完全相同，低分化鳞状细胞癌凋亡细胞数量明显多于正常上皮组织和高分化癌组织。免疫组化法检测发现，正常子宫颈和鳞状细胞癌组织中均有ｃａｓｐａｓｅ－３蛋白表达，阳性细胞的数量和分布区域与同一标本凋亡细胞一致。子宫颈鳞癌组织中，可见 Ｂａｘ蛋白异常表达，但阳性细胞比表达ｃａｓｐａｓｅ—３的细胞少，主要为某些间质细胞。双重荧光染色显示，部分Ｂａｘ及ｃａｓｐａｓｅ—３蛋白阳性细胞同时可见凋亡阳性染色。Ｂｃｌ－ ２蛋白在子宫颈癌组织中的表达与正常对照组织比较没有明显差异。结论：正常子宫颈组织及鳞状细胞癌组织中均有不同程度的细胞凋亡。ｃａｓｐａｓｅ－３及Ｂａｘ／Ｂｃｌ－２比值升高参与细胞凋亡的调节。同组织中，不同种类细胞凋亡的调控机制不完全相同。
OBJECTIVE: To investigate the regulatory mechanism of apoptotic cells in cervical squamous cell carcinoma by detecting the expression of apoptosis and some related proteins. Methods: The expression of Bax, Bcl-2 and caspase-3 in normal cervix and squamous cell carcinoma with different differentiation degrees were detected by TUNEL and double immunofluorescence staining. Confocal microscopy was used to observe the results. Results: TUNEL assay showed that each sample had different degree of apoptosis, but the quantity and distribution area were not exactly the same. The number of apoptotic cells in poorly differentiated squamous cell carcinoma was significantly higher than that in normal epithelial tissue and well differentiated carcinoma. The results of immunohistochemistry showed that the expression of caspase-3 protein in normal cervix and squamous cell carcinoma tissues was consistent with the number of apoptotic cells in the same specimen. In squamous cell carcinoma of the cervix, abnormal expression of Bax protein was observed, but fewer positive cells expressed caspase-3, mainly some stromal cells. Double fluorescent staining showed that some Bax and caspase-3 protein positive cells were positive for apoptosis at the same time. Bcl-2 protein expression in cervical cancer tissue compared with normal control group no significant difference. Conclusion: There are different degrees of apoptosis in normal cervical tissue and squamous cell carcinoma. The ratio of caspase-3 and Bax / Bcl-2 is involved in the regulation of apoptosis. In the same tissue, different types of apoptosis control mechanisms are not exactly the same.