乳腺癌中凋亡与细胞增殖及Rb、bcl-2、c-myc蛋白表达的关系

目的：了解人乳腺癌中凋亡与细胞增殖的关系，以及与相关基因蛋白表达的关系及其预后意义。方法：用免疫组化ＬＳＡＢ法检测了９０例乳腺标本（包括１３例良性乳腺病变和７７例乳腺癌）中Ｒｂ、ｂｃｌ２和ｃｍｙｃ的蛋白表达；并计数了癌组织中的凋亡指数（ＡＩ，ＴＵＮＥＬ法）和有丝分裂指数（ＭＩ）。结果：ＡＩ与ＭＩ呈显著的正相关（ｒ＝０８１，Ｐ＜００１）；ＡＩ、ＭＩ和Ｒｂ蛋白表达与肿瘤大小和组织学分级有关，ＡＩ、ＭＩ低和ｂｃｌ２的高表达与５年生存率有关，ｃｍｙｃ的表达仅与组织学等级有关（Ｐ＜００５）；Ｒｂ表达与ＡＩ、ＭＩ均有关（Ｐ＜００１），而ｂｃｌ２的表达仅与ＡＩ有关（Ｐ＜００５）。结论：乳腺癌中凋亡与细胞增殖和ｂｃｌ２表达有关，提示凋亡在具有不同生长潜能的亚群的克隆性选择中发挥重要作用。Ｒｂ与凋亡的关系提示细胞凋亡与细胞周期有关。

Relationship between apoptosis and cell proliferation and expression of Rb, bcl-2 and c-myc proteins in human breast cancer

Purpose To investigate the relationship between apoptosis and cell proliferation and the expression of the related genes as well as their prognostic significance in human breast cancer. Methods Using immunohistochemical method, the expression of Rb, bcl 2 and c myc proteins was investigated in paraffin sections of 90 breast samples comprising 13 breast benign diseases and 77 breast carcinomas. The TUNEL positive cells were counted as apoptosis index (AI) and mitotic cells as mitotic index (MI) . Results It was noted that a significant correlation existed between AI and MI ( r=0 81,P<0 01) , AI,MI and Rb expression were related to the tumour size and histologic grade. The lower AI and MI values as well as less bcl 2 expression were attributed to the 5 year survival groups. c myc expression was only related to histologic grade (P<0 05) ; Rb expression was related to both AI and MI(P<0 01), but bcl 2 expression was only related to AI ( P <0 05). Conclusion Apoptosis in breast cancer shows to be correlated to cell proliferation and bcl 2 expression, which indicates that apoptosis may play a role in the selection of clonal subpopulation with different growth potential. The relationship between Rb and apoptosis implies that apoptosis may be involved in cell cycle.