胆囊肿瘤组织中细胞凋亡及bcl-2基因的研究

Apoptosis and expression of bcl-2 gene in gallbladder neoplasms

目的探讨细胞凋亡及其调控基因ｂｃｌ２在胆囊癌发生发展中的作用．方法用原位末端标记法（ＩＳＥＬ）和免疫组化ＡＢＣ法对２４例胆囊癌和１６例胆囊腺瘤中的凋亡细胞及其调控基因ｂｃｌ２的表达产物进行了检测．同时观察胆囊癌中的调亡细胞与胆囊癌病理类型、分化程度和浸润转移的关系，分析ｂｃｌ２基因对细胞凋亡的调控作用．结果胆囊癌、胆囊腺瘤中的细胞凋亡发生率分别为１００％和５６％；胆囊癌中的凋亡细胞数明显高于胆囊腺瘤（χ２＝３６１１１，Ｐ＜００１）；低分化腺癌及Ｎｅｖｉｎ分期Ｓ１～Ｓ３胆囊癌中的凋亡细胞数明显高于高分化及Ｎｅｖｉｎ分期Ｓ４，Ｓ５者（χ２＝１９０５１，Ｐ＜００１）．高分化腺癌中的凋亡细胞多呈点状分布，低分化腺癌及转移性胆囊癌中的凋亡细胞呈片状或块状分布．ｂｃｌ２基因在胆囊癌和胆囊腺瘤中的表达无显著差异（χ２＝１１１１，Ｐ＞００５）．在胆囊癌中，ｂｃｌ２产物阳性表达与细胞凋亡密切相关（χ２＝１１８２，Ｐ＜００１）．

AbstractAIM To investigate the effects of apoptosis and bcl-2 gene in gallbladder neoplasms.METHODS The number of apoptosis and the bcl-2 positive expression rate were observed in 24 cases of gallbladder carcinomas and 16 gallbladder adenomas,using in situ and labeling (ISEL) method and immunohistochemical staining.RESULTS The incidence and number of apoptosis in gallbladder adenoma was significantly lower than in gallbladder carcinoma (Nevin stage S4,S5) (5.6% vs 100%,χ2=36.115,P<0.01), and well differentiated gallbladder carcinoma had less apoptosis cells than poorly differentiated gallbladder carcinoma (Nevin stage S1-S3, χ2=19.05,P<0.01). In bcl-2 positive expression, there was no significant difference between gallbladder carcinoma and gallbladder adenoma (χ2=1111,P>0.05). The expression of bcl-2 was related to apoptosis in gallbladder carcinoma (χ2=11.82,P<0.01).CONCLUSION The rate of apoptosis may be a perfect prognostic index for gallbladder carcinoma, and apoptosis may play an important role in the pathogenesis of gallbladder carcinoma.