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目的 了解结肠良、恶性病变中细胞凋亡与增殖 ,及其与相关基因蛋白表达的关系及其生物学意义。方法 应用免疫组织化学S P法检测 14 8例结肠良、恶性病变标本中bcl 2、bax和PCNA蛋白的表达 ;并对其中 75例标本进行凋亡指数 (AI)和有丝分裂指数 (MI)测定。结果 PCNA与AI和MI密切相关 (P <0 .0 1) ;而bcl 2和bax仅与AI有关 (P <0 .0 1) ;bcl 2和PCNA蛋白在结肠腺癌和腺瘤中表达率显著高于正常组织 (P <0 .0 1) ;而bax蛋白则相反 ,在正常及良性病变中表达率较癌组织为高 (P<0 .0 1)。其次发现 ,以结肠腺瘤为分界点 ,前半阶段凋亡指数逐渐上升 ,后半阶段则下降 ,而细胞增殖指数在整个演进过程中呈上升趋势。结论 凋亡与增殖间平衡的破坏与结肠粘膜的恶变密切相关 ,在这一过程中有多种基因参与调控 ,其中bcl 2和bax即参与了此调控过程 ,且其蛋白产物的异常表达是结肠腺癌发生过程中的早期事件。
Objective To understand the apoptosis and proliferation of benign and malignant lesions of the colon, and its relationship with the expression of related gene proteins and their biological significance. Methods The expression of bcl-2, bax and PCNA protein in the specimens of benign and malignant colon were detected by immunohistochemistry SP method. The apoptotic index (AI) and mitotic index (MI) of 75 specimens were determined. Results PCNA was closely related to AI and MI (P < 0.01), but bcl 2 and bax were only related to AI (P <0.01); the expression rates of bcl 2 and PCNA in colon adenocarcinoma and adenoma Significantly higher than normal tissue (P <0. 1); whereas bax protein was the opposite, and the expression rate was higher in normal and benign lesions than in cancerous tissue (P <0. 01). Secondly, we found that with the colon adenoma as the cut-off point, the apoptotic index increased gradually in the first half stage and decreased in the second half stage, while the cell proliferation index showed an upward trend throughout the evolution process. Conclusion The destruction of the balance between apoptosis and proliferation is closely related to the malignant transformation of colonic mucosa. In this process, there are many genes involved in the regulation, and bcl 2 and bax are involved in this regulation process, and the abnormal expression of the protein product is colon Early events in the development of adenocarcinoma.