伴神经内分泌分化非小细胞肺癌中p53、bcl-2及c-myc的表达

Study on the specific expressions of p53, bcl-2 and c-myc in non-small cell lung cancer with neuroendocrine differentiation

目的 研究伴神经内分泌 (neuroendocrine,NE)分化的非小细胞肺癌 (NSCLC)中p53、bcl 2和c myc的特异性表达。方法 随机搜集 60例手术切除的NSCLC石蜡标本 ,采用免疫组化S P法检测神经元特异性烯醇化酶 (NSE)、嗜铬颗粒蛋白A(CgA)、突触素 (Syn)及p53、bcl 2、c myc基因蛋白的表达。结果 NSCLC中NSE、CgA、Syn的阳性表达率分别为 45 .0 0 % (2 7/ 60 )、1 3 .33% (8/ 60 )、31 .67% (1 9/ 60 )。结合三者的表达确定伴有NE分化的占 41 .67% (2 5/ 60 ) ;NE分化与肺癌的分化程度有密切关系 (P <0 .0 5) ;伴神经内分泌分化非小细胞肺癌 (NSCLC NE)的转移率较高 ,临床分期较高。NSCLC NE中bcl 2、p53和c myc的阳性表达率分别为68.0 0 % (1 7/ 2 5)、80 .0 0 % (2 0 / 2 5)和 68.0 0 % (1 7/ 2 5) ,其中bcl 2、p53的表达与NE分化有密切关系 (P <0 .0 5)。结论 NSCLC中有相当一部分伴有NE分化 ,NSCLC NE具有与其它NSCLC不同的生物学特性。NSCLC NE中可以检测到高表达的bcl 2蛋白、突变型p53蛋白 ,p53突变导致的bcl 2 /Bax的失衡在NSCLC

Objective To study the specific expression of tumor related genes (p53, bcl 2 and c myc) in non small cell lung cancer with neuroendocrine differentiation (NSCLC NE). Methods The expression of neuron specific enolase (NSE), chromogranin A (CgA), synaptophysin(Syn), c myc, bcl 2 and p53 was detected in 60 surgically resected and paraffin embedded non small cell lung cancer (NSCLC) specimens by immunohistochemistry (S P method). Results The positive rates of NSE, CgA, Syn expressed in 60 cases of NSCLC were 45.00%(27/60), 13.33%(8/60), 31.67% (19/60) respectively. According to the results of these three markers, 41.67%(25/60) of 60 specimens was proved to be as NE differentiation cancer. The NE differentiation in NSCLC was remarkably related to differentiation of tumor cells (P<0.05). NSCLC NE had a higher metastatic rate (P<0.05) and a higher clinical staging (P<0.05) than NSCLC without NE differentiation. The positive rates of bcl 2, p53 and c myc expression in NSCLC NE were 68.00% (17/25), 80.00% (20/25), 68.00% (17/25) respectively, and the expression of bcl 2 and p53 was closely related to NE differentiation (P<0.05). Conclusion A certain part of NSCLC have NE differentiation, which has different biological features from NSCLC without NE differentiation. High expression of bcl 2 and mutant p53 can be observed in NSCLC NE, and bcl 2/Bax unbalance associated with p53 mutation may play an important role in oncogenesis and development of NSCLC NE.