乳腺癌和癌前病变中细胞凋亡及其与bcl-2、PCNA表达的关系

Apoptosis and immunohistochemical bcl 2、PCNA expression in breast carcinoma and precancerous lesions

目的：探讨细胞凋亡在乳腺癌变过程中的作用及其与细胞增殖以及ｂｃｌ２、ＰＣＮＡ表达的关系。方法：利用ＴＵＮＥＬ法及免疫组化ＳＰ法检测５４例乳腺癌及２７例非癌病变中细胞凋亡指数（ＡＩ）以及ｂｃｌ２、ＰＣＮＡ的表达；同时计算核分裂指数（ＭＩ）。结果：“正常”乳腺上皮、增生性导管、原位癌及浸润性癌的ＡＩ和ＭＩ分别为：０１０％±０１２％、０３１％±０４３％、０４１％±０２１％、０７４％±０５６％和００２％±００５％、００１％±０１６％、０２２％±０１７％、０５７％±０３５％（Ｐ＜００５）；ＡＩ与ＭＩ呈正相关（ｒ＝０８７，Ｐ＜００１），且随着病变的发展，ＡＩ／ＭＩ呈下降的趋势。“正常”乳腺上皮、增生性导管、原位癌、浸润性癌中ｂｃｌ２、ＰＣＮＡ表达率分别为：６８４２％、６２５０％、５５５６％、４８８９％和２６３２％、３７５０％、６６６７％、８８８９％；ＰＣＮＡ表达与ＭＩ呈正相关（ｒｓ＝１，Ｐ＜００１）。癌组织中，ｂｃｌ２高表达者ＡＩ显著低于ｂｃｌ２低表达者。结论：细胞凋亡和细胞增殖均参与乳腺癌变的过程，ｂｃｌ２在乳腺癌中具有抑凋亡作用，且ｂｃｌ２表达?

Purpose To explore the role of apoptosis in breast carcinogenesis and the relationship between apoptosis and cell proliferation and bcl 2、PCNA expression. Methods The methods of TUNEL and immunohistochemical S P were used to investigate the occurence of apoptosis and bcl 2、PCNA expression in 81 female breast carcinomas and 27 cases noncancer lesions. Apoptosis index( AI ) and mitotic index ( MI ) were calculated in all of the tissues. Results AI and MI in normal breast epithelial tissues, hyperplastic ductal tissues, carcinomas in situ and invasive ductal carcinoma tissues were 0 10%±0 12%、0 31%±0 43%、0 41%±0 21%、0 74%±0 56% and 0 02%±0 05%、0 01%±0 16%、0 22%±0 17%、0 57%±0 35% respectively ( P <0 05). There was a significant direct correlation between them ( r =0 87, P <0 01). The incidences of bcl 2 and PCNA positivity in normal breast epithelial tissues, hyperplastic ductal tissues, carcinomas in situ and invasive carcinoma tissues were 68 42%、62 50%、55 56%、48 89% and 26 32%、37 50%、66 67%、88 89% respectively. Breast carcinomas expressing bcl 2 were significantly more likely to have low AI . Conclusion Both apoptosis and cell proliferation take part in breast carcinogenesis. Bcl 2 is responsible for inhibition of apoptosis in breast carcinomas, and the loss of bcl 2 expression is a relatively late event in the progression of breast carcinoma.