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目的探讨Caspase-9,Caspase-3,Bcl-2蛋白与瘢痕癌癌细胞凋亡的相关性。方法以15例病理性皮肤瘢痕被覆上皮、20例皮肤瘢痕癌组织为研究对象,以10例正常皮肤表皮为对照。采用免疫组织化学技术(SP法)分别检测三组组织中Caspase-9,Caspase-3,Bcl-2蛋白的表达;原位末端标记(Tunel法)检测以上三种组织中细胞的凋亡水平。结果 Caspase-9在正常皮肤表皮和病理性皮肤瘢痕上皮呈阴性表达,在瘢痕癌组织呈弱阳性表达。瘢痕癌组与正常皮肤、病理性瘢痕组比较,差异均有统计学意义(P<0.01);正常皮肤组与病理性瘢痕组比较,差异无统计学意义(P>0.05)。Caspase-3在正常皮肤表皮和病理性皮肤瘢痕上皮呈阳性,在瘢痕癌组呈弱阳性。瘢痕癌组与正常皮肤组和病理性瘢痕组比较,差异均有统计学意义(P<0.01),但正常皮肤组与病理性皮肤瘢痕组比较,差异无统计学意义(P>0.05)。Bcl-2在正常皮肤表皮和病理性瘢痕上皮中仅见于基底层和棘细胞层有少量表达,呈阴性,在瘢痕癌组织中呈阴性表达。其表达水平、表达强度在三组之间比较差异无统计学意义(P>0.05)。凋亡指数在正常皮肤组和病理性瘢痕组高于瘢痕癌组,且差异有统计学意义(P<0.05),但正常皮肤组与病理性瘢痕组比较,差异无统计学意义(P>0.05)。结论瘢痕癌的发生与癌细胞凋亡抑制有关,而凋亡抑制可能与Caspase-9,Caspase-3的表达抑制有关,而与Bcl-2的抗凋亡作用可能没有相关性。
Objective To investigate the relationship between Caspase-9, Caspase-3 and Bcl-2 protein and the apoptosis of cancer cells in scar. Methods 15 cases of pathological skin scars covered epithelium, 20 cases of skin scar cancer tissue as the research object, 10 cases of normal skin epidermis as a control. The expressions of Caspase-9, Caspase-3 and Bcl-2 protein in three groups were detected by immunohistochemistry (SP method). The levels of apoptosis in the above three tissues were detected by Tunel method. Results Caspase-9 was negatively expressed in the normal skin epidermis and pathological skin scar epithelium, but weakly positive in the scar tissue. Compared with normal skin and pathological scar group, the difference between the two groups was statistically significant (P <0.01). There was no significant difference between normal skin group and pathological scar group (P> 0.05). Caspase-3 is positive in normal skin epidermis and pathological skin scar epithelium, and weakly positive in scar cancer group. Compared with normal skin group and pathological scar group, the differences between the two groups were statistically significant (P <0.01), but there was no significant difference between normal skin group and pathological skin scar group (P> 0.05). Bcl-2 was only found in the basal and spine layers in normal and pathological scar epithelium, with a small amount of expression, which was negative and negative in scar tissue. The expression level and expression intensity of the three groups showed no significant difference (P> 0.05). The apoptosis index was higher in normal skin group and pathological scar group than in scar group (P <0.05), but there was no significant difference between normal skin group and pathological scar group (P> 0.05 ). Conclusions The occurrence of scar cancer is related to the inhibition of apoptosis of cancer cells. However, the inhibition of apoptosis may be related to the inhibition of the expression of Caspase-9 and Caspase-3, but may not be related to the anti-apoptotic effect of Bcl-2.