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目的 探讨人肺癌细胞增殖、凋亡水平与患者预后的关系。方法 应用免疫组化法检测核增殖相关抗原 Ki- 67的表达水平 ,应用 TUNEL法检测细胞凋亡水平。结果 ( 1 )肺癌组织中Ki- 67指数 ( KI)增高与组织学类型、细胞分化程度显著相关 ,而凋亡指数 ( AI)与患者 P- TNM分期、淋巴结转移状态显著相关 ;( 2 )高 KI组肺癌患者的术后生存时间显著低于低 KI组 ,按 P-TNM分期分层后这种差异仍然存在 ;( 3) 、 期肺癌患者中高 AI组术后生存时间显著低于低AI组 ,而在 、 期肺癌患者中显著高于低 AI组。结论 KI反应肺癌细胞的增殖状态 ,对预后判断有一定价值 ;AI反映机体清除损伤细胞的一种自稳态机制 ,还不能认为是一个稳定、独立的预后指标。
Objective To investigate the relationship between the proliferation and apoptosis of human lung cancer cells and the prognosis of patients. Methods Immunohistochemical method was used to detect Ki-67 expression and TUNEL was used to detect apoptosis. Results (1) The increase of Ki-67 index (KI) in lung cancer tissues was significantly correlated with histological type and cell differentiation, while the apoptotic index (AI) was significantly associated with P-TNM stage and lymph node metastasis; (2) The survival time of lung cancer patients in the KI group was significantly lower than that of the low-KI group. This difference was still present after stratification by P-TNM; the survival time of the high-AI group in the patients with lung cancer was significantly lower than that of the low AI group. , but in patients with lung cancer, significantly higher than the low AI group. Conclusion The proliferation status of lung cancer cells stimulated by KI has a certain value for prognosis. AI reflects a kind of self-stability mechanism of eliminating dead cells in the body and cannot be considered as a stable and independent prognostic indicator.