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目的:探讨大肠腺瘤中细胞凋亡和增殖相关基因的表达与意义。方法:用脱氧核糖核酸末端转移酶介导的TUNEL法缺口末端标记和免疫组化技术,检测45例大肠腺瘤组织细胞的原位凋亡(AI)、原值增殖(KI)及bcl-2、bax基因表达;并设立20例正常大肠粘膜和40例大肠癌为对照组,探讨细胞凋亡和细胞增殖在大肠癌早期发生中的作用。结果:正常结肠粘膜有少量的bcl-2、bax和ki-67(用KI表示)表达及少量凋亡细胞存在,但无异常表达。大肠腺瘤中bcl-2表达和KI明显增加,与正常组相比P均<0.05;AI和bax表达轻度增加,与正常相比P0.05;大肠癌组织中AI和bax表达明显增加且与腺瘤组相比P<0.05。结论:大肠癌发生早期即腺瘤中就有细胞凋亡调控基因及增殖基因的表达异常,且以抗凋亡基因bcl-2和增殖基因表达占主导地位。该基因的表达异常可能是大肠癌发生的一个较早期分子标志;细胞凋亡增加和bax表达异常可能是大肠癌发生的一个相对较早期分子生物学事件。早期检测抗细胞凋亡基因和增殖基因,有助于对大肠癌早期发生的评估。
Objective: To investigate the expression and significance of apoptosis-related and proliferation-related genes in colorectal adenoma. Methods: Apoptotic cells (AI), proliferative index (KI) and bcl-2 in 45 cases of colorectal adenoma were detected by TUNEL nick end labeling and immunohistochemistry. , Bax gene expression; and set up 20 cases of normal colorectal mucosa and 40 cases of colorectal cancer as control group, to explore the role of apoptosis and cell proliferation in the early occurrence of colorectal cancer. Results: A small amount of bcl-2, bax and ki-67 (expressed as KI) and a few apoptotic cells were found in normal colonic mucosa, but no abnormal expression was found. The expression of bcl-2 and KI in colorectal adenoma were significantly increased, P <0.05 compared with the normal group; the expression of AI and bax increased slightly, P <0.05 compared with normal. There was a positive correlation between bax and AI expression (P <0.01). There was a negative correlation between bcl-2 and bax AI expression. The expression of bcl-2 and KI in colorectal cancer increased, but there was no significant difference compared with that of adenoma (P> 0.05). The expression of AI and bax in colorectal cancer increased significantly compared with that of adenoma (P <0.05). Conclusion: The expression of apoptosis-controlling genes and proliferating genes in the early stage of colorectal adenoma is abnormal, and the expression of anti-apoptotic gene bcl-2 and proliferation gene are dominant. The abnormal expression of this gene may be an earlier molecular marker of colorectal cancer. Increased apoptosis and abnormal bax expression may be a relatively early molecular biological event in colorectal cancer. Early detection of anti-apoptotic and proliferative genes contributes to the assessment of the early occurrence of colorectal cancer.