Bcl-2、Bax在胃癌及胃癌前病变中的表达与细胞凋亡的关系

目的 探讨胃癌及胃癌前病变组织中Bcl-2、Bax的表达情况及其与细胞凋亡的相互关系.方法 采用免疫组织化学SP法分别检测10例正常胃黏膜、60例慢性萎缩性胃炎伴肠化生、30例异型增生、50例胃癌中Bcl-2、Bax蛋白的表达情况,采用末端脱氧核苷酸转移酶介导的dUTP缺口末端标记技术（TUNEL法）检测组织切片中细胞凋亡的情况.结果 慢性萎缩性胃炎伴肠化生、异型增生、胃癌中Bcl-2蛋白表达阳性率分别为31.7％,43.3％,62.0％,均显著高于正常胃黏膜（P＜0.01）.慢性萎缩性胃炎伴肠化生、异型增生中Bax蛋白阳性率分别为55.0％,30.0％,其阳性率均显著高于胃癌（P＜0.01,P＜0.05）.Bcl-2蛋白表达阳性慢性萎缩性胃炎伴肠化生、异型增生和胃癌中凋亡细胞指数（AI）显著低于Bcl-2蛋白阴性组（P＜0.05）,Bcl-2蛋白表达阳性率与AI值呈负相关.Bax蛋白表达阳性慢性萎缩性胃炎伴肠化生、异型增生和胃癌中AI显著高于Bax蛋白阴性组（P＜0.05）,Bax蛋白表达阳性率与AI值呈正相关.结论 胃黏膜癌变过程中,AI、凋亡调控基因Bcl-2和Bax的比值逐渐增加,说明它们在胃癌演变过程中可能起重要作用.

Relationship between Bcl-2 and Bax expressions in gastric carcinoma and precancerous lesions and apoptosis

Objective To investigate the relationship between Bcl -2 and Bax expressions in gastric carcinoma and precancerous lesions and apoptosis. Methods The Bcl -2 and Bax expressions in 10 cases of normal gastric mucosa ,60 cases of intestinal metaplasia ,30 cases of epithelial dysplasia of stomach and 50 cases of gastric carci- nomas were detected by immunohistochemical SP method. The apoptosis index was examined by TUNEL method. Rusuits The Bcl - 2 - positive cell rate in intestinal metaplasia, epithelial dysplasia of stomach and gastric carci- nomas were 31.7% ,43.3% and 62.0% ,respectively ,which was significantly higher than that in the normal gas- tric mucosa （P 〈0.01 ）. The Bax- positive cell rate in intestinal metaplasia and epithelial dysplasia of stomach were 55.0% and 30.0% , respectively,which was significantly higher than that in gastric carcinomas （P 〈 0.01, P 〈 0.05 ）. The apoptotic index （AI） of Bcl -2 - positive expression in intestinal metaplasia, epithelial dysplasi- a of stomach and gastric carcinomas groups was lower than that in Bcl - 2 - negative expression goups （ P 〈 0. 05 ）. There was a negative correlation between AI and Bcl - 2 - positive cell rate. AI of Bax - positive expression in intestinal metaplasia, epithelial dysplasia of stomach and gastric carcinomas groups were higher than that in Bax - negative expression goups （P 〈 0.05 ）. There was a positive correlation between AI and Bax - positive cell rate. Conclusion The increased AI and the ratio of Bcl - 2 and Bax might play an important role in the pathogen- esis of gastric carcinoma.