口腔扁平苔藓细胞凋亡及凋亡蛋白Bcl-2、Bax表达的变化

目的观察口腔扁平苔藓（oral lichen planus, OLP）病损区口腔黏膜超微结构的变化,以及Bcl-2 、Bax和凋亡细胞的表达水平,探讨细胞凋亡在OLP发生、发展中的作用。方法选取35例OLP患者和10例健康志愿者（对照组）。采用免疫组织化学法检测0LP患者和正常对照组口腔黏膜组织中Bcl-2 、Bax的表达,应用TUNEL法及流式细胞术检测上皮细胞的凋亡情况,应用透射电镜技术观察口腔黏膜超微结构的变化。采用SPSS17.0软件包对数据进行统计学处理。结果免疫组织化学检测显示,Bcl-2在OLP中的阳性表达率与正常口腔黏膜相比无显著差异（P>0.05）,但在淋巴细胞浸润带处表达增强。Bax在OLP中的阳性表达率和表达强度与正常口腔黏膜相比显著增高（P<0.01）。OLP病变组织的上皮细胞凋亡指数显著高于对照组（P<0.01）,与流式细胞术测定结果一致（OLP组上皮细胞凋亡百分率显著高于对照组）。透射电镜观察发现,OLP组口腔黏膜凋亡细胞增多,染色质边聚,并见凋亡小体。结论凋亡细胞表达上调以及病损区超微结构改变,病损区淋巴细胞浸润带处Bcl-2 与上皮基底层角质形成细胞中Bax的表达增强,证实细胞凋亡异常与OLP 的发生、发展有密切关系。

The expression and changes of apoptosis protein Bcl-2 and Bax in oral lichen planus

PURPOSE:To analyze the changes in epithelial cells, and observe the expression of Bcl-2, Bax and apoptosis in oral lichen planus. METHODS: Thirty five OLP patients and 10 healthy volunteers were enrolled in this study. Immunohistochemical S-ABC was used to detect Bcl-2 and Bax expression in OLP group and control group. TUNEL and flow cytometry were used to study the apoptosis of the epithelial cells. Transmission electron microscope (TEM) was used to observe the changes of ultra-microstructure of oral membrane of OLP. The data was analyzed with SPSS 17.0 software package. RESULTS: The expression of Bcl-2 in OLP group was not significantly different from control group (P>0.05), but the expression was remarkably elevated in lymphocyte infiltration zone. Bax positive expression rate and intensity in OLP group significantly increased compared with the control group (P<0.01). The apoptosis index was remarkably increased in the epithelial cells in OLP group compared with the control group (P<0.01), which was consistent with the result of flow cytometry(the apoptotic percentage of the epithelial cells in OLP group was significantly higher than the control group). TEM showed that the apoptotic cells of mucous membrane of OLP increased, with chromatin margination, and apoptotic body. CONCLUSIONS: The ultra-microstructure change in the lesional tissue, increased apoptotic cells, elevated Bcl-2 in lymphocyte infiltration zone and elevated Bax in epithelial basement keratin suggest that apoptosis may be related to the carcinogenesis and development of OLP.