幕上星形细胞瘤的凋亡及相关基因p53、bcl—2的表达

目的 探讨幕上星形细胞瘤的细胞凋亡以及p53、bcl-2在凋亡中的意义。方法 免疫组化TUNEL法检测细胞凋亡，SP法检测p53、bcl-2，实验数据由SPSS软件包分析处理。结果 细胞凋亡指数（AI）随着肿瘤级别的增高而增加，各级别肿瘤间AI的差异均有显著性意义（P＜0．01）；死亡组与存活组的AI的差异有显著性意义（P＜0．01），AI＞0．5％组与AI＜0．5％组的术后1年生存率的差异有显著性意义（P＜0．05）；AI／MI（分裂指数）在高、低级别的星形细胞瘤中的差异有显著性意义（P＜0．05）。p53阳性组与p53阴性组的AI、MI术后1年生存率的差异均有显著性意义（均P＜0．05）。bcl-2阳性组与阴性组的AI、MI、预后均无统计学意义（均P＞0．05）。多因素logistic回归分析年龄分组、AI、AI／MI、放疗均与预后优劣相关。结论 AI可以作为提示预后的指标，并对判断幕上星形细胞瘤的生物学行为及肿瘤分级有指导意义；AI／MI值越小，肿瘤的恶性转化能力越强，预后越差；p53过度表达提示肿瘤恶性程度高、预后差；AI＜0．5％、AI／MI值大的、年龄较轻的、术后放疗病人预后较好。

Apoptosis in supratentorial astrocytomas and expression of apoptosis related gene p53 and bcl-2

Objective To investigate apoptosis in supratentorial astrocytomas and its relationship with p53?bcl 2 proteins. Methods Immunohistochemical staining (TUNEL?SP) were used in present study. The statistical data was analysed by spss software. Results AI increases with increasing anaplasia acrossed the spectrum of astrocytomas. There was statistical significant difference between random two grade of tumors. AI in died group was significantly higher than what in living group. The patient with AI<0 5% had better prognosis. AI/MI was with significant difference between high and low grade tumors. AI and MI in positive p53 were significantly higher than what in negative p53. There were no statistical significantly difference between positive bcl 2 and negative bcl 2. AI, AI/MI, age grouping and post operational irradiation were all associated with prognosis with logistic regression analysis. Conclusions It suggests that AI is an factor to predict prognosis. It can guide to determine the biological behaviors of supratentorial astrocytoma and tumor grading. The tumor with low AI/MI has more potential to anaplastic transformation and an expected poor prognosis.p53 overexpression is dominant in high grade astrocytomas, which suggests a poor clinical course. Considering above four factors(age grouping, AI, AI/MI and irradiation) together may have more prognostic value.