细胞凋亡及Ki-67蛋白在口腔粘膜白斑与鳞癌组织中的表达及意义

Significance of the Apoptosis and Expression of Ki-67 in Leukoplakia and Oral Squamous Cell Carcinoma

目的 :研究口腔正常粘膜、粘膜白斑及鳞癌组织中细胞凋亡及Ki 6 7蛋白表达及其意义。方法 :用TUNEL法检测口腔粘膜白斑和鳞癌中细胞凋亡 ,用免疫组化SP法检测细胞Ki 6 7蛋白表达 ,并计算其细胞凋亡率及细胞增殖率。结果 :在正常粘膜 单纯增生性白斑 不典型增生性白斑 鳞癌过程中 ,随病变的发展 ,其细胞凋亡率呈下降趋势 (分别为 3.5 5 % ,3.4 5 % ,3.34%及 2 .38% )。细胞增殖率呈上升趋势 (分别为 2 9.4 5 % ,2 9.6 6 % ,31.30 %及 31.5 6 % )。相邻病变类型两两比较 ,细胞凋亡率在不典型增生性白斑与鳞癌中的差异有高度显著性 (P<0 .0 1) ;细胞增殖率在单纯增生性白斑与不典型增生性白斑相比中 ,差异有高度显著性 (P <0 .0 1)。结论 :提示口腔粘膜白斑 ,尤其是不典型增生性白斑如出现较低的细胞凋亡率和 /或较高的细胞增殖率 ,应注意癌变的可能性。

Objective: To investigate the apoptosis and expression of Ki-67 in leukoplakia (LK) and oral squamous cell carcinoma (OSCC) and their relationship to the morphological variation,and to elucidate the mechanism of carcinogenesis of LK. Methods: Pathological changes were observed by HE staining and apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) and the expression of Ki-67 protein by immunohistochemical SP method in 41 cases of LK and 24 cases of OSCC.Results: The rate of apoptosis decreased along with pathological changes from 3.45% in simple hyperplasia (SH) to 3.34% in atypicalhy-perplasia(AH) and then to 2.28% in OSCC. The rate of Ki-67 expression increased from 29.66% in SH to 31.30% in AH and then to 31.56% in OSCC. The rate of Ki-67 expression showed notable difference between SH and AH ( P< 0.01).Conclusion: The attention should be paid to the possibility of carcinogenesis of LK when lower rate of apoptosis and/or higher rate of cell proliferation was detected in LK,especially in AH. In the process of carcinogenesis of LK,cell proliferation plays a prime role in the early phase and apoptosis more significantly affects the progress of from LK to OSCC in the late phase.