p53,bcl-2,caspase-3在老年晚期非小细胞肺癌组织中的表达及对预后的影响

Expression of p53,bcl-2,caspase-3 and effect on prognosis in tissues of elderly patients with advanced NSCLC

目的探讨p53、bcl-2、caspase-3在117例老年晚期非小细胞肺癌组织中的表达与预后的关系。方法收集经手术后病理学检查确诊的117例老年晚期NSCLC患者的临床资料和存档石蜡组织标本。免疫组织化学方法检测肿瘤组织中p53、bcl-2、caspase-3蛋白的表达情况,分析p53、bcl-2、caspase-3蛋白表达的相关性,及其与患者临床病理学特征、与预后之间的关系。结果 NSCLC组织中bcl-2与caspase-3表达成显著正相关(r=0.262,P=0.003)。117例老年晚期NSCLC组织标本中,p53、bcl-2、caspase-3的阳性表达率分别为42.74%(50/117)、38.46%(45/117)、36.75%(43/117)。p53阳性表达率在低分化、中央型、有淋巴结转移的鳞癌患者中较高(P<0.05);bcl-2阳性表达率在高分化、有淋巴结转移患者中较高(P<0.05);caspase-3阳性表达率在高分化、无淋巴结转移患者中较高(P<0.05)。非小细胞肺癌组织中p53、bcl-2表达阳性的患者2年生存率显著低于表达阴性的患者(P<0.05);而非小细胞肺癌组织中caspase-3表达阳性的患者2年生存率与表达阴性的患者之间无明显差异(P>0.05)。结论 p53、bcl-2、caspase-3可能在老年晚期NSCLC的发生和发展过程中起重要调控作用,可作为判断老年晚期NSCLC患者预后的参考指标。

Objective To investigate the expression of p53, bcl-2 and caspase-3 in tissues of 117 elderly patients with advanced non-small cell lung cancer （NSCLC）, and explore its clinical significance. Methods The clinical data and paraffin tissue samples of 117 patients with NSCLC confirmed by postoperative pathology were collected. The expression of p53, bcl-2 and caspase-3 protein in tissues of NSCLC was detected by immunohistochemical method, the correlation among the expression of p53, bcl-2 and caspase-3 protein was analyzed, and the relationship between the expression of p53, bcl-2 and caspase-3 protein and clinicopathological characteristics or between the expression of p53, bcl-2 and caspase-3 protein and survival was explored. Results The expression of bcl-2 was significantly positively related to that of caspase-3 in tissues of NSCLC （r=0.262, P=0.003）. The positive expression rates of p53, bcl-2, caspase-3 in tissues of NSCLC were 42.74% （50/117）, 38.46% （45/117）, 36.75% （43/117）, respectively in 117 patients. Patients with poor differentiation, central type, lymph node metastasis and squamous carcinoma had higher positive expression rates of p53. High differentiation, lymph node metastasis had higher expression rates of bcl -2, and high differentiation, no lymph node metastasis had higher positive expression rates of caspase-3. The 2-year survival rates of patients with positive expression of p53 and bcl-2 in tissues of NSCLC were significantly lower than those with negative expression （P〈 0.05）. The 2-year survival rates of patients with positive expression of caspase-3 in tissues of NSCLC were not significantly dif-ferent than those with negative expression （P〈 0.05）. Conclusion The p53, bcl-2 and caspase-3 may play important roles in the development and progression of elderly patients with advanced NSCLC, and may serve as predicators for prognosis.