中国人和日本人胰腺癌组织中pBcl-2和pBax表达的比较

Comparison of pBcl-2 and pBax Expression in Primary Invasive Ductal Pancreatic Cancer between Chinese and Japanese Patients

目的比较中国和日本人胰腺浸润性导管癌中pBcl-2和pBax的表达情况,研究二者与胰腺癌患者预后之间的关系。方法采用免疫组织化学方法,检测59例中国和65例日本胰腺浸润性导管癌患者癌组织中pBcl-2和pBax的表达情况,并进行比较。结果在59例中国患者中,pBcl-2和pBax的阳性表达率分别为35.6%和49.2%;在65例日本患者中,二者的阳性表达率分别为23.1%和64.7%。在男性患者和组织学中分化的患者中,pBcl-2的表达中日间差异有显著性(χ2=4.447,P=0.035;χ2=4.114,P=0.043);在65岁以上人群中,pBax的表达中日间差异也有显著性(χ2=6.657,P=0.010)。中日pBcl-2(+)组患者的术后中位生存时间与pBcl-2(-)组相比差异有显著性(χ2=9.99,P=0.0016;χ2=7.63,P=0.0058);日本pBax(+)组患者的术后中位生存时间与pBax(-)组相比差异有显著性(χ2=9.37,P=0.0022);中日pBcl-2(+)组之间及pBax(+)组之间术后生存时间相比差异均有显著性(χ2=4.48,P=0.0342;χ2=5.23,P=0.023)。结论pBcl-2和pBax在中日胰腺癌患者中均有较高的表达。在中日两国患者中,pBcl-2表达均提示较好的预后。pBax表达在日本患者中可提示较好的预后,而在中国患者中却没有显著意义。

Objective To clarify the clinicopathologic significance of the expression of the Bcl-2 protein （pBcl-2） and the Bax protein （pBax）, and their clinical implications in Chinese and Japanese patients with human invasive ductal carcinomas （IDCs） of the pancreas. Methods The study included 59 Chinese and 65 Japanese patients with IDCs of the pancreas, pBcl-2 and pBax expression were immunostained with streptavidin-biotin （SAB） method. Results pBcl-2 （＋） was seen in 35.6% of Chinese and in 23.1% of Japanese patients, pBax （＋） was seen in 49.2% of Chinese and 64.7% of Japanese patients. A comparison between them showed that there were significant differences in the male patients, in the patients with the moderately differentiated cancer, and in the elderly patients （χ^2=4.447, P=0.035; χ^2= 4.114, P=0.043; χ^2=6.657, P=0.010 respective）. In both Chinese and Japanese patients, those with pBcl-2 positive expression had a significantly higher survival rate than those with negative one （χ^2=9.99, P=0.0016; χ^2=7.63, P=0.0058）. The group with pBax positive expression had a significantly higher survival rate in Japanese patients （χ^2=9.37, P=0.0022）. Japanese patients whose tumors exhibited pBcl-2 and pBax positive immunostaining survived significantly longer than Chinese patients did （χ^2=4.48, P=0.0342; χ^2= 5.23, P=0.023）. Conclusions The expressions of both pBcl-2 and pBax are high found in Chinese and Japanese patients. The pBcl-2 positive expression implies a better prognosis in both Chinese and Japanese patients with IDCs of the pancreas. The effect of pBax expression on prognosis is different between Chinese and Japanese patients.