胸腺瘤伴重症肌无力患者瘤组织中Bcl-2和Fas的表达水平

目的 探讨凋亡相关基因bcl-2、Fas在胸腺瘤伴重症肌无力患者瘤组织中的表达状况及其临床意义。方法经手术治疗的25例胸腺瘤伴重症肌无力患者的肿瘤组织标本为病例组，25例先天性心脏病患者手术时切取的正常胸腺组织标本为对照组，通过免疫组化的方法检测两组标本中Bcl-2和Fas蛋白的表达水平。结果胸腺瘤中Bcl-2及Fas表达水平均显著高于对照组，经Ridit分析两者差异均有统计学意义（U值分别为2．645、3．200，P均〈0．05），但Bcl-2和Fas的表达水平与胸腺瘤患者的重症肌无力Ossermen分型、术前病程、年龄及性别等临床因素均无显著相关。结论 Bcl-2和Fas在胸腺瘤伴重症肌无力的发病中可能具有重要作用。

The level of Bcl-2 and Fas expression in thymoma tissue from patients with myasthenia gravis

OBJECTIVE: To evaluate the clinical significance of expression levels of apoptosis-associated genes, bcl-2 and Fas in thymoma tissue from patients with myasthenia gravis. METHODS: The study included 25 patients who underwent maximal thymectomy because of concurrent thymoma and myasthenia gravis. Clinical staging (Osserman classification) showed stage I in 6, IIA in 3, IIB in 13 and III in 3 cases. According to the WHO classification of thymomas (1999), 5, 3, 7, 7, and 3 patients had type A, AB, B1, B2, and B3, respectively, and no patient had type C. As a control group, the normal thymic tissue from 25 patients with congenital heart diseases was studied. The expression level of Bcl-2 and Fas in the tissue of thymoma and normal thymus was detected by immunohistochemistry. RESULTS: Bcl-2 and Fas expressions were significantly higher in thymomas compared with normal thymus by Radit analyses (U = 2.645, P < 0.05 and U = 3.200, P < 0.05, respectively). The expression level of Bcl-2 and Fas showed no relation to the course of the disease, age, Osserman classification and sex. CONCLUSION: The result suggests that the two apoptosis-associated factors, Bcl-2 and Fas, may play important roles in the pathogenesis of thymoma concurrent with myasthenia gravis.