子宫内膜增殖症与子宫内膜癌细胞凋亡的相关性研究

The related study on apoptosis in endometrial hyperplasia and adenocarcinoma.

目的：探讨子宫内膜增殖症和子宫内膜癌细胞凋亡及其与凋亡相关基因产物表达的关系。方法：应用ＴＵＮＥＬ法检测正常增殖期、增殖症及癌变子宫内膜组织标本的凋亡细胞，应用组免法检测Ｂｃｌ２、Ｐ５３、Ｆａｓ及ＦａｓＬ抗原。结果：（１）与正常增殖期相比，增殖症子宫内膜腺上皮细胞中凋亡细胞比率高，Ｂｃｌ２ 蛋白含量高，Ｆａｓ、ＦａｓＬ蛋白含量低下；（２）内膜癌癌细胞中凋亡细胞比率高，Ｂｃｌ２蛋白含量低，１／３标本中Ｆａｓ、ＦａｓＬ蛋白含量丰富；（３）Ｐ５３ 仅存在于１２％ 的内膜癌细胞核内。结论：增殖症内膜凋亡细胞增多显示了良性病变内膜中细胞凋亡对过度增生的抑制。内膜癌细胞凋亡增多则与Ｂｃｌ２ 低表达，Ｆａｓ、ＦａｓＬ高表达及Ｐ５３部分表达相伴，表明癌变内膜中细胞凋亡调控受多种基因表达的影响。

Objective:To investigate the association between apoptosis and expression of apoptosis related genes in endometrial hyperplasia and adenocarcinoma.Methods:Apoptotic cells were detected by TUNEL.Bcl 2,P53,Fas,Fas L expressions were examined using immunohistochemistry assay.Results:(1)Apoptotic cells were more in hyperplastic endometrium than that in normal proliferative endometrium,Bcl 2 expression in hyperplastic endometrium was slight higher than that in normal proliferative endometrium,but Fas and Fas L were low in both endometrium.(2)Apoptotic cells were more frequent in cancer cells of adenocarcinoma tissue.But Bcl 2 expression was lower,Fas and Fas L were present in plenty amount in 1/3 samples.(3)P53 antigen was only detected in 12% cancer cases.Conclusions: More apoptotic cells and higher Bcl 2 in hyperplastic endometrium revealed that the apoptosis occured in benign endometrium inhibited hyperplasia.But more apoptotic cells and lower Bcl 2,high Fas and Fas L,partly P53 in adenocarcinoma also revealed that the apoptosis occured in malignant endometrium was controlled by many genes expressions.