脑胶质瘤中细胞凋亡及相关基因Fas、Survivin表达研究

目的探讨脑胶质瘤中细胞凋亡及Fas、Survivin在凋亡中的意义.方法应用末端脱氧核苷酸转移酶介导的脱氧三磷酸尿苷缺口末端标记法(terminal deoxynucleotidyl transferase-mediated-deoxy uridine-5'- triphosphate-X nick end labeling, TUNEL)检测细胞凋亡,免疫组化链酶亲和素-生物素-过氧化物酶复合物 (strept avidin-biotin peroxidase complex, SABC)法检测Fas、Survivin和增殖细胞核抗原(proliferating cell nuclear antigen, PCNA).结果凋亡指数(apoptosis index, AI)随胶质瘤的恶性程度增高而增高(P<0.001).AI/PI则随着胶质瘤级别增高而减小(P<0.001).Fas阳性组的AI较Fas阴性组显著增高(P<0.01).Survivin阳性组的AI较Survivin阴性组显著减低(P<0.05).低AI(<0.94)组与高AI(>0.94)组的术后1年生存率的差异有显著意义(P<0.05).死亡组与存活组的AI差异无显著意义(P=0.34),而两组的AI/PI有显著差异(P<0.001).多因素Logistic回归模型分析显示,病理、Fas、Survivin、AI、AI/PI和手术与预后相关(P<0.01).结论 AI可作提示预后的指标,对脑胶质瘤的生物学行为及肿瘤分级有指导意义.肿瘤级别较低、Fas 阳性、Survivin阴性、AI<0.94%、AI/PI较大、手术全切的患者预后较好.

Apoptosis in brain gliomas and expression of apoptosis related genes Fas and Survivin

Objective To investigate apoptosis in brain gliomas and its relationship with Fas and Survivin proteins .Methods Apoptotic cells and apoptotic bodies were detected by terminal deoxynucleotidyl transferase mediated deoxy uridine 5' triphosphate X nick end labeling(TUNEL). Immunohistochemical stains were performed to examine the expression of Fas, Survivin and proliferating cell nuclear antigen(PCNA).Results Apoptosis index(AI) was associated with the grade of glioma. There were significant positive linear correlations between AI and proliferative index (PI). And AI/PI decreased with the progress of glioma. The mean AI of Fas positive tumors was significantly higher than that of Fas negative tumors. The mean AI of Survivin positive tumors was significantly lower than that of Survivin negative tumors. The postoperative one year survival rate in lower AI (<0.94) group was significantly higher than that in higher AI (>0.94) group. AI/PI in died group was significantly higher than that in living group. Pathological grade, Fas, Survivin, AI, AI/PI and operation were demonstrated to be associated with prognosis of the patients with glioma using Logistic regression analysis. Conclusion AI, as a factor to predict prognosis , can guide to determine the biological behaviors of glioma and histological grading. The results suggest the patients with above six factors ( lower grade tumor, Fas positive, Survivin negative, AI< 0.94 %, higher AI/PI and undergoing total surgical treatment ) would have better prognosis .