子宫肉瘤和子宫肌瘤中bcl-2和bax蛋白的表达及意义

目的：研究凋亡调节蛋白bcl-2及bax在子宫肉瘤和子宫肌瘤中的表达及意义。方法：用免疫组织化学ABC法检测34份子宫平滑肌肉瘤标本（Ⅰ期18例，Ⅱ期1例，Ⅲ期8例，Ⅳ期7例）和34份子宫平滑肌瘤以及34份正常子宫肌层标本中的bcl-2及bax蛋白的表达。结果：子宫肌瘤中bcl-2表达强于子宫肉瘤和正常子宫肌层（P<0.01），肉瘤中的表达强于正常子宫肌层（P<0.05）。正常子宫肌层中bax的表达强于子宫肌瘤和子宫肉瘤（P<0.01），但bax在肌瘤和肉瘤之间的表达无显著性差异（P>0.05）。Ⅰ，Ⅱ期子宫肉瘤中bcl-2和bax蛋白表达均高于Ⅲ，Ⅳ期者（P<0.01）。bcl-2表达阳性的子宫肉瘤的预后好于bcl-2表达阴性者。结论：bcl-2和bax的表达失调在子宫肌瘤和子宫肉瘤的发病机制中起一定作用。bcl-2和bax主要在子宫肉瘤发生的早期起作用，bcl-2与肉瘤预后相关。

Expression of bcl-2 and bax protein in uterine leiomyosarcomas and leiomyomas

OBJECTIVE: To determine the expression and significance of the apoptosis regulatory protein bcl-2 and bax in uterine leiomyosarcomas and uterine leiomyomas. METHODS: The expression of bcl-2 and bax were examined by immunohistochemical ABC staining with specific antibodies in 34 cases of uterine leiomyosarcomas (18 cases in stage I , 1 in stage II , 8 in stage III, and 7 in stage IV ), 34 uterine leiomyomas and 34 normal myometrium samples. RESULTS: Bcl-2 expression was higher in uterine leiomyomas than that in normal myometrium and in uterine leiomyosarcoma (P < 0.01 ); bcl-2 expression in uterine leiomyosarcoma was higher than that in normal myometrium (P < 0.05). Bax expression in normal myometrium was higher than that in leiomyomas and in uterine leiomyosarcoma (P < 0.01). There was no obvious difference in bax expression between leiomyomas and leiomyosarcoma (P > 0.05). Both the expressions of bcl-2 and bax proteins in stage I - II were higher than those of in stage III - IV (P < 0.01). The bcl-2 positive leiomyosarcoma has a favorable clinical outcome than that of bcl-2 negative. CONCLUSION: The imbalance between the expression of bcl-2 and bax may play a certain role in the genesis of the uterine leiomyomas and leiomyosarcomas. Bcl-2 and bax may be involved in the early stage of the tumor genesis of uterine leiomyosarcoma. Bcl-2 might correlate with the prognosis of the uterine leiomyosarcoma.