结肠癌患者细胞凋亡与预后意义的初步研究

An initial study of apoptosis in colorectal cancer patients and its prognostic significance

目的探讨促凋亡蛋白Bid在大肠癌、大肠腺瘤及正常肠黏膜组织的表达差异,了解其在大肠癌生物治疗中的价值。方法应用免疫组化MaxVisionTM快捷法检测正常肠黏膜18例、结肠腺瘤21例及结肠癌83例的Bid表达。结肠癌Dukes分期为A期22例、B期20例、C期20例及D期21例。表达程度采用半定量积分法。结果Bid在结肠腺瘤中阳性表达为95.2%,高于正常肠黏膜(72.2%)及结肠癌(72.3%),前者与后二者相比,差异显著(P<0.05)。结肠癌DukesD期Bid阳性表达100%与A、B期(40.9%、55.0%)相比有极显著差异(P<0.001),DukesD期且有28.6%高表达。在结肠癌的高表达DukesD级病例,虽Bid表达为强阳性但结肠癌细胞仍不受限制持续增殖。结论结肠癌的早期阶段(结肠腺瘤)中Bid阳性率高于结肠癌,说明细胞凋亡属于结肠癌变的早期现象。结肠癌细胞可能存在使抗瘤的T细胞及NK细胞发生免疫识别困难而致免疫逃逸的途经。

Objective The apoptosis of colorectal cancer （CRC） has been received much interest recently because of its positive rate was quite different and its influence on the prognosis of CRC was not well known. Methods Immunohistochemical MaxVision^TM fast method was used to detect the expressions of Bid protein in the cell of 18 cases of normal tissues, 21cases of colon adenomas and 83 cases of colon carcinoma. In 83 cases of colon carcinoma, Duckes＇ stage A was 22 cases, Dukes＇ stage B 20 cases, Duckes＇ stage C 20 cases, and Duckes＇ stage D 21 cases respectively. The semiquantitative scores method was used to observe the expression level. Results The positive rates of Bid protein in colon adenomas were 95.2% and its expressions were higher than those in normal tissues （72.2%） and CRC （72.3 % ）. In the CRC group the expression of Bid in Dukes＇ stage D（100.0% ）was significantly higher than that in Dukes＇stage A（40.9% ） and B （55.0%）,besides, 28.6 % of Dukes＇ stage D were found to be with high expression. Conclusion The positive rate and level of pro-apoptosis protein Bid in advanced CRC patients are high. The clarification of its mechanism would be of prime importance to the future biotherapy of CRC and its prognosis.