口腔粘膜异常增生上皮和鳞癌组织凋亡相关蛋白的表达研究

Expression of apoptosis-related protein in epithelial dysplasia and squamous cell carcinoma

目的 探讨凋亡相关基因p5 3、Bcl 2和Bax在口腔鳞状细胞癌发展各阶段的表达及意义。方法 采用免疫组织化学SP法检测 10例正常口腔粘膜上皮 ,48例异常增生上皮和 42例鳞癌组织中p5 3、Bcl 2和Bax的表达。结果 正常粘膜上皮中p5 3、Bcl 2、Bax影响表达率分别为 0 % ,2 0 %和6 0 % ;异常增生上皮组中 ,相对于正常组 ,p5 3阳性率明显提高 (P <0 0 5 ) ,Bcl 2表达无明显改变 (P >0 0 5 ) ,Bax阳性率亦无改变 (P >0 0 5 ) ,但染色强度随异常增生程度增加而增加 ;鳞癌组p5 3阳性率进一步提高 ,Bcl 2表达明显增强 ,Bax表达随组织学分级增加而下降。相关性分析显示 ,在异常组p5 3和Bax表达呈负相关 ,鳞癌组p5 3和Bcl 2表达显示正相关。结论 癌前病变中 ,p5 3突变导致异常增生上皮积累。鳞癌组织中 ,p5 3和抑凋亡基因Bcl 2作用加强 ,促凋亡因子Bax作用减弱 ,癌细胞凋亡受限 ,侵袭性增强。凋亡基因发挥作用有阶段性 ,它们既相互独立又相互协同 ,相互制约。

Objective To study the expression and significance of apoptosis related protein p53, Bcl 2, and Bax during the development of oral squamous cell carcinoma (SCC). Methods The expression was observed in 10 normal oral epithelia, 48 dysplasia epithelia and 42 SCC by immunohistochemical evaluation. Results In normal mucosa, the positive rate of p53, Bcl 2 and Bax were 0%, 20% and 60%. In dysplasia epithelia, the positive rate of p53 is increased ( P< 0 05), the positive rate of Bcl 2 and Bax remained no significant change ( P> 0 05), but the positive intensity in severe dysplasia was higher than in mild group. In SCC, the positive rate of Bcl 2 increased significantly (compared with dysplasia, P< 0 05), while the expression of Bax was decreased with the increase of SCC histological grade. Further analysis showed the correlation was evident in p53 and Bax in dysplasia, and in p53 and Bcl 2 in SCC. Conclusions In dysplasia, p53 gene mutation results in accumulation of dysplasia cells. In SCC, the cooperation of p53, Bcl 2 and Bax results in the progression of SCC. Apoptosis genes could work either independentely or cooperately.