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目的 :探讨增殖相关基因Ki 6 7和凋亡相关基因Bax、Bcl 2在喉上皮良、恶性疾病中的表达和临床意义。方法 :采用免疫组织化学SP法检测存档石蜡标本喉癌、不典型增生、喉乳头状瘤、声带息肉、喉正常粘膜组织中Ki 6 7和Bax、Bcl 2表达。结果 :Ki 6 7在以上组织中的表达率依次为 5 2 .0 %、5 0 .0 %、4 7.8%、4 1.7%、10 .0 % ,喉癌明显高于喉正常粘膜 4 4 .0 % (P <0 .0 5 ) ,不典型增生明显高于喉正常粘膜 (P <0 .0 5 )。Bcl 2的表达率在不典型增生为 11.0 % ,在喉癌中为 4 4 .0 % ,其余 3组为 0 %。喉癌表达明显高于不典型增生和正常粘膜(P <0 .0 5 ) ,极显著高于喉乳头状瘤和声带息肉 (均P <0 .0 1)。Bax在各组织中表达率依次为 76 .0 %、77.8%、6 9.6 %、5 8.3%、80 .0 % ,各组差异无显著性意义。在喉乳头状瘤中Ki 6 7、Bcl 2表达成正相关 (P <0 .0 5 )。结论 :Ki 6 7、Bcl 2在喉乳头状瘤中的协同表达提示细胞内无法控制的增殖 ;二者有可能是癌变的前提 ,在癌前病变中有一定的诊断价值
Objective: To investigate the expression and clinical significance of proliferation-related gene Ki 6 7 and apoptosis-related genes Bax and Bcl 2 in benign and malignant diseases of the laryngeal epithelium. Methods: The expressions of Ki 6 7, Bax and Bcl 2 in paraffin embedded specimens of laryngeal carcinoma, atypical hyperplasia, laryngeal papilloma, vocal cord polyp and normal laryngeal mucosa were detected by immunohistochemical SP method. Results: The expression rates of Ki67 in the above tissues were 52.0%, 50.0%, 41.8%, 41.7% and 10.0% respectively, and the laryngeal carcinoma was significantly higher than the normal laryngeal mucosa 44. 0% (P <0.05), atypical hyperplasia was significantly higher than normal laryngeal mucosa (P <0.05). The expression of Bcl-2 was 11.0% in atypical hyperplasia, 44.0% in laryngeal carcinoma and 0% in the remaining three groups. The expression of laryngeal carcinoma was significantly higher than that of atypical hyperplasia and normal mucosa (P <0.05), which was significantly higher than that of laryngeal papilloma and vocal cord polyps (P <0.01). The expression rates of Bax were 76.0%, 77.8%, 69.6%, 58.3% and 80.0% in all the groups. There was no significant difference among the groups. There was a positive correlation between Ki67 and Bcl2 expressions in laryngeal papilloma (P <0.05). Conclusion: The synergistic expression of Ki 6 7 and Bcl 2 in laryngeal papilloma suggests uncontrolled cell proliferation. Both of them may be the prerequisite for carcinogenesis and may have some diagnostic value in precancerous lesions