肺癌细胞凋亡及相关基因与其预后关系的初步研究

Preliminary study on relationship among apoptosis and related gene,prognosis of lung cacer

目的观察５７例肺癌石蜡包埋组织中细胞的凋亡现象，探讨该现象与相关基因及肺癌预后的关系。方法采用原位末端ＤＮＡ片段标记法及ＤＮＡ琼脂糖凝胶电泳观察肺癌细胞凋亡现象，应用ＡＢＣ免疫组化法检测ｋｉ－６７，ｂｃｌ－２以及Ｐ５３的表达。结果①凋亡细胞与ｋｉ－６７阳性细胞的数量变化呈高度相关（Ｐ＝０．００１）与患者的临床分期、年龄以及Ｐ５３表达等均无确切关系。②小细胞肺癌中ｂｃｌ－２的表达与凋亡细胞数呈负相关作用。③凋亡及ｋｉ－６７阳性细胞的数量变化与患者平均生存期有关（Ｐ＝０．００５７，Ｐ＝０．００２），即凋亡细胞＞３％，增生细胞＞２０％的病例其平均生存时间分别短于凋亡细胞≤３％、增生细胞≤２０％的病例。结论凋亡与增生细胞的数量变化可作为评价肺癌预后的指标之一。

Objective To observe the relationship among Lung cancer cell apoptosis,proliferation and related gene expression and its significance as an index of prognosis.Method In situ end labelling (ISEL)technique and DNA gel electrophoresis were used to detect the apoptotic cell,immunohistochemistry was used to detect the expression of bcl 2, 53 and ki 67 in 57 cases of Lung cancer. Result The number of apoptotic cells was found to correlated with the ratio of ki 67 positive cell(P=0.001).There was significant correlation between the extent of apoptosis and the expreesion of bcl 2 in SCLC,but this relation was not observed in NSCLC.No correlation was found among apoptotic cells or ki 67 positive cells,staging,age and expression of P 53 .Patients with apoptotic cells greater than 3% and ki 67 greater than 20% possessed shorter survival time than that less than or equal to 3% or 20%,respectively(P=0.0057,P=0.002by logronk).Comclusions Increased apoptotic and proliferous cells are independent prognostic index in lung cancers,predicting shortened survival time of the patients.