肠MALT淋巴瘤细胞凋亡与p53和bcl—2的表达

目的：探讨肠黏膜相关淋巴组织（MALT）淋巴瘤细胞增殖和凋亡的特征以及调亡相关调控基因的表达。方法：应用TUNEL技术检测21例肠淋巴瘤的凋亡指数（apoptosis index,AI)，免疫组化S－P法检测PCNA增殖指数（proliferative index,PI）及bcl-2和p5e蛋白的表达。结果：随着肠MALT淋巴瘤恶性度的增高，AI和PI显著增加，并且二者呈显著正相关。低度恶性、高度恶性伴低度恶性以及高度恶性肿瘤组中，bcl-2阳性率分别为79．4％、57．1％、40．9％。三组bcl-2呈阳性率为AI均差异显著（P＜0．05）。bcl-2与AI呈显著负相关（P＜0．05）。p53阳性率为31．4％。高度恶性组p53阳性率显著高于其余两组。p53与bcl-2表达呈负相关（P＜0．05）。结论：凋亡和增殖在肿瘤的发生、发展、转化中起着重要作用，检测AI、PI可能是诊断恶性淋巴瘤、评价其生物学行为的可靠指标。在MALT的恶性度从低到高的转化中，p53和bcl-2基因可能起着重要作用。

Correlation of apoptosis with the expression of p53 and bcl-2 in primary intestinal mucosa-associated lymphoid tissue (MALT) lymphoma

Objective To investigate the characteristics of apoptosis and proliferation and the expression of apoptosis associated antigens in intestinal MALT lymphoma. Methods Terminal dUTP nick end labeling (TUNEL) technique was used to detect apoptotic cells, and immunohistochemical staining to show the expression of p53, bcl-2 and proliferating cell nuclear antigen (PCNA) in 70 cases of intestinal MALT lymphomas. Results Apoptotic index (AI) and proliferative index (PI) increased significantly as the histological grade advanced. Positive correlation of AI with PI (r=0.8058, p<0.05) was found. Bcl-2 was expressed in 79.4% of low grade, 57.1% moderate grade and 40.0% high grade tumors. An inverse correlation was observed between the expression of bcl-2 and AI (p<0.05). Expression of p53 was found in 31.4% of intestinal MALT lymphomas. Positive rate of p53 protein was significantly increased as the histological grade of the tumors advanced (p<0.05). There was also an inverse correlation between the expression of p53 and bcl-2 proteins in the MALT lymphoma. Conclusions Apoptosis and proliferation may be important in development and progression of the tumor. Detection of AI and PI provides reliable data for the diagnosis of intestinal MALT lymphoma and for evaluation of its biological behaviors. P53 and bcl-2 are important apoptosis regulating genes that play an important role in the transformation from low grade to high grade lymphomas.