小儿颅内胶质瘤组织中B淋巴细胞瘤-2基因(BCL-2)蛋白和胶质纤维酸性蛋白(GFAP)检测的临床价值及意义

Clinical Value and Significance of Detection of B Cell Lymphoma 2(BCL-2)and Glial Fibrillary Acidic Protein(GFAP)in Children with Intracranial Glioma

目的检测小儿颅内胶质瘤组织中B淋巴细胞瘤-2基因(BCL-2)蛋白和胶质纤维酸性蛋白(GFAP)的表达,并分析其临床价值和意义。方法选取96例颅内胶质瘤患儿手术切除标本,采用免疫组织化学染色(SP法)检测胶质瘤组织中BCL-2和GFAP的表达,比较不同临床分期该两个指标表达阳性率的差异;然后根据患儿预后情况分为预后良好组(A组,31例)和预后较差组(B组,65例),比较不同预后情况患儿胶质瘤组织中BCL-2和GFAP的表达,并进一步分析其与患儿预后的相关性。结果星形胶质瘤和胶质母细胞瘤患儿H-SCORE得分显著高于室管膜瘤患儿(P<0.05),而该两组相比差异无统计学意义(P>0.05);Ⅲ~Ⅳ级BCL-2阳性表达率和H-SCORE得分均显著高于Ⅰ~Ⅱ级(P<0.05)。不同组织学分类胶质瘤患儿GFAP表达阳性率无显著差异,但H-SCORE得分则为:胶质母细胞瘤>星形胶质瘤>室管膜瘤患儿,且组间两两比较差异具有统计学意义(P<0.05);Ⅲ~Ⅳ级GFAP阳性表达率和H-SCORE得分均显著高于Ⅰ~Ⅱ级(P<0.05)。与A组相比,B组BCL-2和GFAP的表达阳性率及H-SCORE得分均显著增高(P<0.05)。结论BCL-2和GFAP的表达与胶质瘤患儿组织学分类、病理分级以及预后情况均密切相关,因此在胶质瘤的发生、分化以及进展的调控方面具有重要作用。

Objective To detect the expression of B lymphocyte tumor-2 protein(BCL-2)and glial fibrillary acidic protein(GFAP)in intracranial glioma tissue in children,and analyze its clinical value and significance.Methods The surgical resection specimens of 96 children with intracranial glioma were selected,and immunohistochemical staining(SP method)was used to detect the expression of BCL-2 and GFAP in glioma tissue,and the difference in the positive rate of the two indicators in different clinical stages was compared.Then according to the prognosis of the children,they are divided into good prognosis group(group A)and poor prognosis group(group B),the expression of BCL-2 and GFAP in glioma tissues of children with different prognosis was compared andtheir correlation with the prognosis of children were further analyzed.Results The H-SCORE scores of children with astroglioma and glioblastoma were significantly higher than those of children with ependymoma(P<0.05),but there was no significant difference between the 2 groups(P>0.05);the positive expression rate of BCL-2 and H-SCORE scores of gradeⅢ~Ⅳwere significantly higher than those of gradeⅠ~Ⅱ(P<0.05).There was no significant difference in the positive rate of GFAP expression in children with glioma in different histological classifications.However,the H-SCORE scores were:glioblastoma>astroglioma>ependymoma,and the difference between the 2 groups was statistically significant(P<0.05);the positive expression rate of GFAP and H-SCORE scores of gradeⅢ~Ⅳwere significantly higher than those of gradeⅠ~Ⅱ(P<0.05).Compared with group A,the positive rate of BCL-2 and GFAP expression and H-SCORE score in group B increased significantly(P<0.05).Conclusion The expression of BCL-2 and GFAP is closely related to the histological classification,pathological grade and prognosis of children with glioma,and therefore plays an important role in the regulation of the occurrence,differentiation and progression of glioma.