细胞凋亡及Bcl-2蛋白表达在胃癌发生中的意义

Significance of apoptosis and expression of bcl-2 in gastric pre-carcinoma and cancer

了解细胞调亡和Bcl－2蛋白表达在慢性胃炎、胃溃疡、胃粘膜不典型增生、胃癌中的规律和可能作用。方法：采用原位末端标记法（TUNEL法）检测细胞凋亡，采用免疫级化检测Bcl－2蛋白的表达。结果：慢性活动性胃炎、胃溃疡、轻度不典型增生、重度不典型增生、早期胃癌和进展期胃癌的凋亡指数分别为16．8±12．3％、24．1±20．0％、19．3±16．4％、15．7±15．2％、10．1±9．1％和6．3±6．0％，进展期胃癌显著低于早期胃癌和不典型增生（P＜0．05）。而Bcl－2蛋白阳性率分别为9．4％、27％．6％、52．9％、75．0％、83．3％和46．7％，早期胃癌显著高于进展期胃癌。在Lauren分型中，杨型和弥散型胃癌的细胞凋亡指数、Bcl－2蛋白的表达分别为8．3±7．2％、38．9％和5．1±4．9％、58．3％，两型比较，细胞调亡指数及Bcl－2蛋白表达均有显著差异（P＜0．05）。结论：在胃粘膜不典型增生、早期胃癌到进展期胃癌的发展中，细胞凋亡逐渐受到抑制。胃癌的形成与Bcl－2的高表达有关，而且主要的作用阶段可能在癌变早期。胃癌的Lauren分型与细胞凋亡指数及BcL－2蛋白表达密切相关。

Objective: To clarify the Significance of apoptosis and expression of bcl - 2 in gastric pre - carcinoma and can-cer. Methods :TUNEL methal was used to deect apoptosis. Immunohistochemical analysis was used to detect the expressions ofbcl - 2 protein . Results :In the Patients of chronic active gastritis, gastric ulcer, minor dysplasia , serious dysplasia , carly gastric cancer and advanced gastric cancer, apeptotic indexes were respectively as follows: 16.8 ±12.3% 、 24. 1 ± 20.0% 、 19.3 ±16.4%、15.7 ± 15.2%、 10.1± 9.1% and 6.3 ± 6.0%, the expression rates of bcl - 2 were as follows: 9.4%, 27.6%,52.9%,75 .0%,83 .3% and 46.7%. Apoptotic indexes in advanced gastric cancer was significantly higher than that in early gastric cancer and dysplasia(P < O.05). The expression rates of bel - 2 in early gastric cancer was siedcandy higher than thatin advaned gastric caner. In Lauren classfication, apoptotic indexes and the expression rates of blc - 2 in intestinal and diffuse gastric carcinomas were respectively 8 .3 ± 7 .2%, 38.9% and 5. 1 ±4.9%, 58 .3%, There were significantly difference in spop-totic indexes and the expression of bcl- 2 between intestinal and diffuse gastric carcinomas . Conclusion : From dysplasia ,early gastric ereinomas to advanced the fromation of gastric careinomas are closely related to the high expression of bcl - 2 and it maybe the phenomenon in the eally stage gastric caner. Apoptotic indexes and the expression of bel - 2 are forly relatad to Laurenclassification.