舌鳞癌预后与细胞增殖和凋亡的关系

目的：探讨舌鳞癌预后与细胞增殖和凋亡的关系。方法：采用TUNEL法和免疫组织化学法检测52例舌鳞癌细胞中自发性凋亡水平及Bax、Bcl-2、增殖细胞核抗原（proliferating cell nuclea antigen,PCNA)的表达，及其与预后的关系。结果：舌鳞癌中凋亡指数（apoptosis index,AI)、Bcl-2、Bax和PCNA表达的阳性率分别为55．8％、65．4％、73．1％和100．0％。单因素生存分析显示：舌癌患者生存率降低与Bax低表达（P＝0．0020）、PCNA高表达（P＝0．0179）、Bcl-2/Bax比值＞1（P＝0．0072）和高TNM分期（P＝0．0351）有关，但与Bcl-2表达和凋亡指数无关（P＝0．885，P＝0．3536）。结论：Bax、PCNA、Bcl-2/Bax比值和TNM分期一样具有预后价值，综合分析这些指标有助于识别舌癌的生物学特性并准确判断患者的预后。

Correlation between prognosis and cell proliferation, apoptosis in squamous cell carcinoma of tongue

Objective To study the correlation between prognosis and cell proliferation, apoptosis in squamous cell carcinoma(SCC)of tongue. Methods Using TdT mediated dUTP biotin nick end labeling (TUNEL) for cell apoptosis and immunohistochemical staining for proliferating cell nuclear antigen (PCNA), Bcl 2 and Bax protein expression. Results In SCC of tongue, the positive rates of apoptosis index(AI)?Bcl 2?Bax and PCNA were 55.8%, 65.4%, 73.1% and 100.0% respectively. In the univariate Kaplan Meier analysis, low expression of Bax, high expression of PCNA,Bcl 2/Bax expression ratio>1 and high staging were all associated with lower survival rate (Log rank test, P <0.05, respectively), AI was only correlated with grading. Bcl 2 did not show a significant association with all features. Conclusions The levels of Bax and PCNA expression and Bcl 2/Bax expression ratio have independent prognosis value in squamors cell carcinoma of the tongue. Comprehensive analysis of these parameters can be helpful to identify biological behavior and predict more accurately the prognosis of patients of tongue squamors cell carcinoma.