非霍奇金淋巴瘤中survivin、bcl-2、bax、p53表达及其与细胞增殖和凋亡的关系

目的研究非霍奇金淋巴瘤(non-Hndgkin’s lymphoma,NHL)中survivin、bcl-2、bax和p53指标表达的情况,比较它们在B-NHL和T-NHL中的差异,探讨它们在临床病理实践中的应用价值。方法应用免疫组化、原位凋亡检测及组织芯片技术对190例NHL进行检测。结果①survivin、bcl-2、bax、p53在75例B-NHL中表达的总阳性率分别为70·67%、57·33%、46·67%和36·00%,在115例T-NHL中表达的总阳性率分别为81·74%、44·35%、46·09%和40·00%,其中bcl-2表达在B-NHL和T-NHL之间差异有显著性(P=0·045);②随着B-NHL生物侵袭性的增强,survivin表达率和表达强度升高(P=0·001),bcl-2表达率和表达强度下降(P=0·018);③在低中度侵袭组中,随着NHL生物侵袭性的增强,突变型p53表达率升高;在高侵袭组中p53的表达率反而降低;④随着NHL生物侵袭性的增强,Ki-67表达升高(P=0·014和P=0·002)。结论①survivin是判断NHL恶性及侵袭性有意义的指标,联合检测survivin和bcl-2蛋白的表达情况对判断B-NHL的侵袭性可能有互补作用;②p53表达可用于评价低中度侵袭性NHL的生物学行为;③Ki-67蛋白表达强度是评估NHL肿瘤细胞增殖的良好指标,它对NHL侵袭性的分级具有较为重要的参考价值。

Expression of survivin, bcl-2, bax and p53 in non-Hodgkin's lymphoma and their relationship with the proliferation and apoptosis of cells

Purpose To study the expression of survivin, bcl-2, bax and p53, to compare the difference between B-NHL and T-NHL, and then to explore the significance of their practical application in the clinical pathology. Methods 190 cases of NHL were examined with immunohistochemistry, TUNEL and tissue microarray technique. Results The positive rates of survivin, bcl-2, bax and p53 in 75 cases of B-NHL were 70.67%, 57.33%, 46.67% and 36.00%,while those in 115 cases of T-NHL were 81.74%, 44.35%, 46.09% and 40.00%, respectively, in which only the expression of bcl-2 between B-NHL and T-NHL showed significant difference(P=0.045). With the increasing of the aggressiveness of B-NHL, the expression rates of survivin became higher significantly(P=0.001), while that of bcl-2 decreased(P=0.018). With the increasing of the aggressiveness of low and moderate aggressive groups of NHL, the expression rates of p53 became higher, while the rate showed lower for the highly aggressive NHL. With the increasing of the aggressiveness of B-NHL and T-NHL, the expression rates of Ki-67 became higher significantly(P=0.014 and P=0.002). Conclusions Survivin is a meaningful marker to determine the malignancy and aggressiveness of NHL, and combined detection of survivin and bcl-2 would play a complementary role in evaluation of B-NHL aggressiveness. P53 may be used to determine the biological behavior of low and moderate grade of NHL. Ki-67 is a good marker to determine the proliferation of tumor cells, and has important referential value in determination of the invasiveness of the tumor.