目的探讨细胞凋亡及其调控基因ｂｃｌ２在胆囊癌发生发展中的作用．方法用原位末端标记法（ＩＳＥＬ）和免疫组化ＡＢＣ法对２４例胆囊癌和１６例胆囊腺瘤中的凋亡细胞及其调控基因ｂｃｌ２的表达产物进行了检测．同时观察胆囊癌中的调亡细胞与胆囊癌病理类型、分化程度和浸润转移的关系，分析ｂｃｌ２基因对细胞凋亡的调控作用．结果胆囊癌、胆囊腺瘤中的细胞凋亡发生率分别为１００％和５６％；胆囊癌中的凋亡细胞数明显高于胆囊腺瘤（χ２＝３６１１１，Ｐ＜００１）；低分化腺癌及Ｎｅｖｉｎ分期Ｓ１～Ｓ３胆囊癌中的凋亡细胞数明显高于高分化及Ｎｅｖｉｎ分期Ｓ４，Ｓ５者（χ２＝１９０５１，Ｐ＜００１）．高分化腺癌中的凋亡细胞多呈点状分布，低分化腺癌及转移性胆囊癌中的凋亡细胞呈片状或块状分布．ｂｃｌ２基因在胆囊癌和胆囊腺瘤中的表达无显著差异（χ２＝１１１１，Ｐ＞００５）．在胆囊癌中，ｂｃｌ２产物阳性表达与细胞凋亡密切相关（χ２＝１１８２，Ｐ＜００１）．结论细胞凋亡ｂｃｌ２基因在胆囊癌发生发展中起重要作用 Objective To investigate the role of apoptosis and its regulatory gene bcl2 in the development of gallbladder carcinoma. Methods The expression of apoptotic cells and its regulatory gene bcl2 in 24 gallbladder carcinomas and 16 gallbladder adenomas were detected by in situ end labeling (ISEL) and immunohistochemistry. At the same time, we observed the relationship between apoptotic cells in gallbladder carcinoma and the pathological type, differentiation and invasion and metastasis of gallbladder carcinoma, and analyzed the regulation effect of bcl2 on apoptosis. Results The incidence of apoptosis in gallbladder carcinoma and gallbladder adenoma was 100% and 5.6%, respectively; the number of apoptotic cells in gallbladder carcinoma was significantly higher than that in gallbladder adenoma (χ2=36111, P<001). The number of apoptotic cells in poorly differentiated adenocarcinoma and Nevin stage S1-S3 gallbladder carcinoma was significantly higher than those in well-differentiated and Nevin stages S4 and S5 (χ2=19051, P<001). The apoptotic cells in well-differentiated adenocarcinoma mostly distributed in spots. The apoptotic cells in poorly-differentiated adenocarcinoma and metastatic gallbladder carcinoma were distributed in flaky or massive patterns. The expression of bcl2 gene in gallbladder carcinoma and gallbladder adenoma showed no significant difference (χ2=1111, P>005). In gallbladder carcinoma, the positive expression of bcl2 product is closely related to apoptosis (χ2=1182, P<001). Conclusion Apoptosis bcl2 gene plays an important role in the development of gallbladder carcinoma