喉癌细胞周期各时相的细胞凋亡检测及意义

目的:探讨细胞周期各时相的细胞凋亡在喉癌发生、发展及预后中的作用。方法:结合387例喉鳞癌患者的随访资料,应用流式细胞仪(FCM)双参数分析和脱氧核苷酸原位末端标记(TUNEL)技术,检测15例声带息肉和387例喉鳞癌细胞周期各时相的细胞凋亡。结果:喉鳞癌组细胞凋亡明显低于声带息肉组(P<0.05),而且主要由G0G1期细胞凋亡的下降所引起;细胞周期各时相的细胞凋亡和肿瘤的临床分型、临床分期及T分级无显著性相关;高分化鳞癌和中分化鳞癌的细胞凋亡未见显著性差异,但是低分化鳞癌S期、G2M期和总的细胞凋亡指数明显增加(P<0.05);5年内死亡组与复发转移组的S期、G2M期和总的细胞凋亡指数明显增加(P<0.05);5年内死亡组与复发转移组G0G1期的细胞凋亡指数明显高于存活5年以上组和未复发转移组(P<0.05),而与声带息肉组无明显差异。结论:G0G1期细胞凋亡的明显下降是喉癌发生过程中的一个早期事件;总的细胞凋亡指数的变化并不能准确反应喉癌的预后;在综合考虑细胞凋亡与细胞周期因素的条件下,S期、G2M期和总的细胞凋亡指数的明显增加可以作为喉癌恶性度高、预后不良、需要辅助治疗的客观指标。

Detection and significance of apoptosis index in each phase of the cell cycle in laryngeal carcinoma

Objective: To discuss the role of apoptosis in each phase of the cell cycle on the occurrence, development and prognosis of laryngeal carcinoma. Methods: The TUNEL technique and FCM parameter analyses were used to detect the apoptosis in each phase of the cell cycle in 15 cases of polyp of vocal cord and 387 cases of laryngeal carcinoma. Results: The apoptosis in laryngeal carcinoma was obviously lower than that in polyp of vocal cord, and this phenomenon was mainly caused by the decrease of the apoptosis in G0G1 phase. Cell cycle and the apoptosis wasn't notably related to clinical stage, clinical type and T grade. The total apoptosis index, and the apoptosis indices in S and G2M phases were obviously enhanced in the poorly-differentiated cancer(P<0.05), and this result was also observed both in the group of recurrence and in the patients who died in 5 years after the operation. There was no significant difference between the well-differentiated and moderately-differentiated cancers. The apoptosis index in G0G1 phase in the group of recurrence and patients who died in 5 years after the operation was higher than that in the group of norelapse and patients who lived more than 5 years after the operation, but it didn't show significant difference with that in the group of polyp of vocal cord. Conclusion: The obvious decrease of the apoptosis in G0G1 phase was an early affair in the initial stage of laryngeal carcinoma. The total apoptosis index change couldn't accurately foretell the prognosis of laryngeal carcinoma, and the significant increase of the total apoptosis index, the apoptosis indices in S and in G2M phases could be regarded as an indicator of malignant larynx cancer with poor prognosis and of necessity of assistant therapy.