大肠癌及癌前病变中Bcl-2、Ki-67、C-erbB-2蛋白的表达及意义

The study of the expression of Bcl-2,Ki-67,C-erbB-2 protein in the colorectal carcinoma and its precancerous lesion

目的:探讨Bcl-2、Ki-67、C-erbB-2在大肠癌与腺瘤中的表达变化规律及发展和转化过程中的作用。方法:采用免疫组化方法检测58例大肠癌、36例大肠腺瘤、20例正常大肠黏膜,分别进行了Bcl-2、Ki-67、C-erbB-2蛋白的检测。结果:Bcl-2阳性表达率在腺瘤与腺癌中基本相同,阳性表达强度腺癌明显高于腺瘤(P<0.01),腺瘤和腺癌的阳性表达强度及表达率与正常大肠黏膜相比差异有显著性(P<0.01)。Ki-67在腺癌中的表达强度及表达率明显高于腺瘤(P<0.01)。C-erbB-2在腺癌中的阳性表达率及表达强度显著高于腺瘤及正常黏膜(P<0.01),有淋巴结转移者明显高于无淋巴结转移者(P<0.01)。结论:Bcl-2在大肠组织的恶性转化中起着重要作用;Ki-67的阳性表达及表达强度对诊断腺癌和监视腺瘤癌变有重要意义;C-erbB-2的过表达与大肠癌的发生、发展密切相关,可作为判断大肠癌恶性程度、淋巴结转移及预后的重要参考指标。

Objective：To investigate the rule of the expression of Bcl-2,Ki-67,C-erbB-2 and their role in the course of occurring and development in eoloreetal carcinoma and adenoma.Methods：Immunohistoehemieal method was used to exam- ine the expression of Bcl-2,Ki-67,C-erbB-2 in 58 eoloreetal carcinoma,36 eoloreetal adenoma and 20 normal eoloreetal mucosa. Results：The positive rate of Bcl-2 in adenoma was almost the same as in carcinoma. The expression intensity in carcinoma was significantly higher than that in adenoma （P〈0.01）.The expression intensity and positive rate of Bcl-2 in adenoma and carcinoma were significantly more stronger than those in normal colon mucosa（P〈0.01）.The expression intensity and positive rate of Ki-67 in carcinoma were significantly higher than in adenoma （P〈0.01）.There were signitficant difbetween carcinoma and adenoma,normal mucosa in the expression intensity and positive rate of C-erbB-2（P〈0.01）. The expression intensity and positive rate of C-erbB-2 in eolorectal carcinoma were significantly higher than the one in eoloreetal adenoma （P〈0.01）,and in patients who have lymph node metastasis were significantly higher than that without lymph node metastasis（P〈0.01）.Conclusion：Bcl-2 plays an important role in malignant transformation of eolorectal mucosa. The expression positive rate and intensity of Ki-67 are important to judge carcinoma and watch the pathway of adenoma. The overexpression of C-erbB-2 is closely associated with the occurrence and development of eoloreetal carcinoma.It serves as an important parameter for judging the maligrnant degree of eolorectal carcinoman,metastasis and predicting of lymph node.