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摘要:目的 探讨B淋巴细胞瘤-2相关X蛋自(Bax)、髓样细胞白血病-1(Mcl-1)及生存素(Sunvivin)在脑胶质瘤中的表达及意义。方法 收集汕头大学医学院第一附属医院神经外科手术切除的脑胶质瘤组织标本48例及同时期由于颅脑外伤进行颅内减压手术的脑组织标本48例作为正常对照。采用免疫组化法检测脑胶质瘤组织及正常脑组织Bax、Mcl-1及Survivin蛋白表达。结果 脑胶质瘤组织中Bax阳性率显著低于正常组织(31.25% vs 70.83%，P<0.O1)，Mcl-1及Survivin阳性表达率显著高于正常组织(79.17% vs 39.58%,0 vs 77.08%，P均<0.0l)。Bax在Ⅲ~Ⅳ级脑胶质瘤中的阳性表达率显著低于Ⅰ~Ⅱ级(18.18% vs 53.84%，P<0.05)；Mcl-1及Survivin在脑胶质瘤Ⅲ~Ⅳ级中阳性表达率显著高于Ⅰ~Ⅱ级(90.91% vs 57.69%，100.00% vs 50.00%，P均<0.01)。脑胶质瘤中Bax与Mcl-1表达负相关(r=-0.532，P=0.000)，Bax与Survivin表达负相关(r=-0.349，P=0.000)，Mcl-1与Survivin表达正相关(r=0.465，P=0.000)。结论 低表达的Bax，高表达的Mcl-1及Survivin与脑胶质瘤的恶性程度密切相关，联合检测可能成为脑胶质瘤诊断的有效指标。
Abstract: Objective To investigate the expression and significance of Bcl-2, Mcl-1 and Sunvivin in gliomas. Methods Forty-eight patients with glioma surgically resected from Department of Neurosurgery, First Affiliated Hospital of Medical College of Shantou University and 48 patients with brain tissue decompression during craniocerebral trauma at the same time were enrolled as normal controls. The expression of Bax, Mcl-1 and Survivin in glioma tissue and normal brain tissue were detected by immunohistochemistry. Results The positive rates of Bax in glioma tissues were significantly lower than those in normal tissues (31.25% vs 70.83%, P <0.01). The positive rates of Mcl-1 and Survivin in glioma tissues were significantly higher than those in normal tissues (79.17% vs 39.58%, 0 vs 77.08%, both P & lt; 0.0l). The positive rates of Bax in grade Ⅲ ~ Ⅳ glioma were significantly lower than those in grade Ⅰ ~ Ⅱ (18.18% vs 53.84%, P <0.05). The positive rates of Mcl-1 and Survivin in gliomas Ⅲ ~ Ⅳ The expression rates were significantly higher than those in grades Ⅰ ~ Ⅱ (90.91% vs 57.69%, 100.00% vs 50.00%, both P <0.01). There was a negative correlation between the expression of Bax and Survivin in gliomas (r = -0.532, P = 0.000), Bax and Survivin (r = -0.349, P = 0.000) r = 0.465, P = 0.000). Conclusion The low expression of Bax, high expression of Mcl-1 and Survivin are closely related to the degree of malignancy of gliomas. Combined detection may be an effective indicator for the diagnosis of gliomas.