Bcl-2蛋白表达与乳腺癌预后相关的病理参数的研究

目的：探讨Ｂｃｌ－２蛋白在乳腺癌及良性乳腺病变中的表达，观察Ｂｃｌ－２蛋白与乳腺癌预后参数的关系。方法：采用免疫组化方法检测 ６９例浸润乳癌，４５例导管原位癌（ｄｕｃｔａｌｃａｒｃｉｎｏｍａ ｉｎ ｓｉｔｕ，ＤＣＩＳ），１５例正常乳腺组织，３８例乳腺良性增生病变中Ｂｃｌ－２蛋白表达。结果：Ｂｃｌ－２蛋白在浸润乳癌，ＢＣＩＳ，乳腺良性增生病变以及正常乳腺组织阳性率分别为６５．２％，７５．６％，１００％，１００％。Ｂｃｌ－２蛋白表达与乳腺癌好的预后参数有关，如肿瘤体积小，低的组织学分级，ＥＲ、ＰＲ阳性，坏死出现少（Ｐ＜０．０１），低ｐ５３蛋白表达（Ｐ＜０．０５），与腋淋巴结浸润没有关系（Ｐ＞０．０５）。大部分乳腺癌表现 Ｂｃｌ－２＋／ｐ５３－表达表型，多属于高分化和中分化病例。而正常乳腺组织，良性增生病变中均为 Ｂｃｌ－２＋／ｐ５３－表达表型。结论：①Ｂｃｌ－２蛋白在正常乳腺组织、良性增生病变的表达高于乳腺癌的表达。②Ｂｃｌ－２蛋白表达与好的乳腺癌预后因素有关。③Ｂｃｌ－２与ｐ５３两种基因蛋白负相关。

The correlation between expression of bcl-2 protein and prognosis indicator in breast carcinoma

Objective: To study the expression of bcl-2 protein in breast carcinoma and benign breast hyperplasia. To observethe relationship between bcl-2 protein expression and prognostic indicators of breast carcinoma. Methods: 69 cases of invasivebreast carcinoma,45 cases of ductal carcinoma in situ (DCIS) ,38 cases benign hyperplasia and 15 cases normal breast tissuewere studied for the expression of bcl-2 protein by means of immunohistochemistry. Results: The expression of bcl-2 protein ininvasive breast carcinoma,DCIS,benign hyperplasia and normal breast tissue were 65.2% ,75.6%, 100% and 100%. Bcl-2protein expression is associated with a number of favorable prognosis factors, such as small rumor size, low histologic grade, ERand PR positivity, less necrosis(P＜0.01) and low p53 protein(P＜0.05). It was found that the status of axillary lymph nodeinvasion didn' t correlate with the expression of bcl-2 protein (P＞0.05). Bcl-2+/p53-phenotype was expressed in mostlybreast carcinoma, it was seen almost in cases of well-differentiated and intermediately-differentiated. Bcl-2 +/p53- phe notypewas consistently expressed in normal breast tissue, benign hyperplasia. Conclusion: ①Bcl-2 protein expression has been foundto higher in normal breast epithelium and benign breast proliferative lesions than in breast carcinoma. ② A relationship hasbeen reported between bcl-2 protein expression and good prognosis factors. ③Immunohistochemical detection of bcl-2 protein isrelated in versely to p53 protein expression.