肝门胆管癌中bcl一2的表达及临床意义

Expression and significance of bcl-2 in hilar cholangiocarcinoma

目的探讨bcl-2表达在肝门胆管癌发生、发展中的作用,评价其在肝门胆管癌预后判断中的价值。方法免疫组织化学法检测36例肝门胆管癌和10例正常胆管石蜡切片标本中bcl-2表达,分析其与肝门胆管癌临床病理参数和术后生存率的关系,生存率计算采用Kaplan-Meier法,Log-rank检验比较生存曲线。结果肝门胆管癌中bcl-2阳性表达率为55.6%(20/36),正常胆管bcl-2阳性率10.0%(1/10),两者差异有统计学意义(P<0.05);bcl-2阴性组术后1、3、5年存活率分别为82%,55%和25%,阳性组分别为33%和9%,无5年生存者,两组差异有统计学意义(P<0.05)。结论肝门胆管癌中bcl-2有较高阳性表达率,bcl-2表达在肝门胆管癌发生、发展中可能起促进作用;bcl-2表达可能是肝门胆管癌预后因素之一,阳性表达多提示预后不良。

Objective To evaluate the significance of bcl-2 expression in predicting prognosis and in the genesis and development of hilar cholangiocarcinoma. Methods The expression of bcl-2 was detected by SP immunohistochemical staining in paraffin sections from 36 cases of hilar cholangiocarcinomas and 10 normal bile duct specimens. Log-rank test and Kaplan-Meirer method were used in compar/ng survival curve and the survival rate. The relationship between the positive rate of bcl-2 expression and the clinical pathological parameters in hilar cholangiocarcinoma, and between the positive rate of bcl-2 expres-sion and the post-operative survival rate were analyzed by statistical software package SSPS13.0. Results The positive rate of bcl-2 expression in hilar cholangiocarcinoma tissue was 55.6% （20/36） ,while that in normal bile duct tissue was 10.0% （1/10） with significant difference between them （ P 〈 0.05）. The post-operative 1-,3-,and 5-year overall survival rates were 82% ,55% and 25% respectively in bcl-2 negative group. But in bcl-2 positive group,the 1-and 3-year overall survival rates were only 33% and 9% ,no 5-year survivor. Significant difference was observed between the two group （P 〈 0.05）. Conclusion Upregulated expression of bcl-2 can be found in hilar cholangiocarcinoma. Increased expression of bcl-2 may promote the genesis and development of hilar cholangiocarcinoma, bcl-2 expression may be one of prognostic factors in the tumor. Positive expression of bcl-2 clues on poor prognosis.