bcl-2基因调控作用与细胞凋亡在神经母细胞瘤发生发展中的作用

The Role of bcl2 Gene Regulating Function and Apoptosis in Oncogenesis of Neuroblastoma

目的：探讨ｂｃｌ－２基因调控作用与细胞凋亡在神经母细胞瘤（ＮＢ）发生发展中的作用。方法：应用ＬＳＡＢ免疫组化及ＴＵＮＥＬ技术检测ＮＢ中ｂｃｌ－２蛋白表达和细胞凋亡。结果：１７例ＮＢ均有ｂｃｌ－２蛋白表达阳性细胞及凋亡细胞，表达指数（ＢＥＩ）９．８％～６１．８％，凋亡指数（ＡＩ）２０‰～１６７‰，二者呈负相关。年龄＜１岁、Ⅰ～Ⅱ及Ⅳ－Ｓ期、ＦＨ型ＮＢ的ＢＥＩ低于年龄≥１岁、Ⅲ～Ⅳ期及ＵＨ型，但差异无显著性意义。ＡＩ在不同分组间差异有显著性意义，且ＡＩ与术后生存时间呈正相关。结论：ｂｃｌ－２基因异常表达可能与神经母细胞或原始神经嵴细胞逃脱凋亡，不能正常成熟或消退，而发展成ＮＢ及ＮＢ的进展有关。ＡＩ高预后好。ＢＥＩ和ＡＩ的检测可为了解ＮＢ的发病机制和判断预后提供实验依据及手段。

Objective: To investigate the role of bcl2 gene in regulating function and apoptosis in the oncogenesis and progression of neuroblastoma (NB). Methods: bcl2 protein expression and apoptosis were detected by standard streptavidinbiotin immunoperoxidase (LSAB) method and terminal deoxynucleotidyl transferasemediated dUTP nick end labeling (TUNEL) method in 17 cases of NB. Results: bcl2 protein and apoptosis were detected in all cases with bcl2 protein expression index (BEI) 9.8%￣61.8% and apoptotic index (AI) 20‰￣167‰. There was a negative correlation between BEI and AI. BEI of cases under 1 year of age or in early stage (stage Ⅰ, Ⅱ), and favourable histopathologic (FH) type was lower than that of cases over 1 year of age, or in advancing stage (stage Ⅲ, Ⅳ) and unfavourable histopathologic (UH) type difference was not apparent (P>0.05). AI was significantly higher in cases less than 1 year of age or in early stage and FH type (P<0.05, <0.01, <0.05, respectively). There was a positive correlation between AI and survival time. Conclusions: The maturation, regression, and progression of neuroblast and embryonic neural crest cells might be promoted by bcl2 protein. The overexpression of bcl2 protein might play an important role in oncogenesis and prognosis of NB.