非小细胞肺癌凋亡指数与Bax表达的临床病理意义

The clinicopathologic significance of apoptosis index in non small cell lung cancer

目的：探讨非小细胞肺癌组织凋亡指数（AI）与Bax表达的临床病理意义。方法：应用免疫组织化学链霉菌抗生物素-过氧化物酶（S-P）法检测46例非小细胞肺癌切除标本以及23例癌旁正常肺组织的Bax表达情况，同时应用末端脱氧核苷酸转移酶介导的dUTP原位切口末端标记（TuNEL）法检测非小细胞肺癌及癌旁正常肺组织AI的大小，并比较不同年龄、不同病理类型、临床分期、不同级别、淋巴结有无转移患者Bax的表达和AI的大小。结果：肺鳞癌与肺腺癌组织中Bax的阳性表达率分别为52．38％、64．00％，低于癌旁肺组织（91．30％）（P〈0．05），不同临床病理特征患者Bax的表达差异无统计学意义（P〉0．05）。肺鳞癌、肺腺癌的AI为（5．67±3．11）％与（6．58±3．58）％，均低于癌旁正常肺组织（14．07±5．16）％（P〈0．05），Ⅲ～Ⅳ期患者AI高于Ⅰ～Ⅱ期患者（P〈0．05），而其它临床病理特征患者AI差异无统计学意义（P〉O．05）。Bax阳性表达的患者AI为（6．93±2．90）％，高于Bax阴性表达的患者（5．04±3．76）％，但差异无统计学意义（P〉0．05）。结论：非小细胞肺癌患者中Bax表达下调、缺失以及AI的下降可能在肿瘤的发生、发展中起一定的作用。

Objective： To study the clinicopathologic significance of apoptosis index（AI） by TUNEL and the expression of Bax in non small cell lung cancer. Methods： The expression of Bax in forty-six resected specimens of non small cell lung cancer （NSCLC） and twenty-three non-tumor lung tissue were detected by S-P immunohistochemistry. Meanwhile,they were investigated the AI by TUNEL. Results： The positive rates of Bax in squamous cell carcinoma and adenocarcinoma were significantly lower than in non-tumor lung tissue （52.38% and 64% vs 91.30%, P 〈0.05） ; The positive expression of Bax have no relationship with tumor type, differentiation, metastasis to lymph node,age and the stage of TNM （P 〉0.05）. Meanwhile, the AI of squamous cell carcinoma and adenocarcinoma were investigated by TUNEL. It showed that both of the AI of squamous cell carcinoma and adenocarcinoma were lower than non-tumor lung tissue [（5.67±3.11）% and （6.58±3.58）% vs （14.07±5. 16）% , P〈0.05], but according to their different clinicopathologic feature （different type, tumor differentiation, metastasis to lymph node, age and the stage of TNM）, they were grouped and compared with each other. It showed that in the patients of the stage Ⅲ～Ⅳ NSCLC were higher than that of the stage Ⅰ～Ⅱ NSCLC statistically （P 〈0.05）. The AI of the patient with Bax positive expression was higher than that of the patient with Bax negative expression, but contrasted with each other, they had no statistic significance [（6.93±2.90）% vs （5.04±3.76）%, P 〉 0.05]. Conclusion： It perhaps had some effect on occurrence and development of NSCLC that the expression of Bax was down regulated and the AI of NSCLC decreased.