细胞凋亡及凋亡相关基因的表达对口腔扁平苔藓预后的影响

Effects of Apoptosis and Expression of Apoptotic Related Genes on Prognosis of Oral Lichen Planus

目的:研究细胞凋亡及凋亡相关基因P53、bcl-2、C-myc的表达对口腔扁平苔藓(OLP)预后的影响。方法:采用TUNEL法及免疫组化法检测45例OLP(糜烂型23例,非糜烂型22例)凋亡细胞情况及P53、bcl-2、C-myc的表达情况并随访至2001年1月。结果:45例OLP均有凋亡细胞发生,凋亡指数(AI)为24.3％,糜烂型(AI=19.0％)明显低于非糜烂型(AI=29.4％,P<0.05);OLP中P53、bcl-2、C-myc表达阳性率分别为31.1％、35.6％、33.3％(糜烂型为39.1％、52.2％、43.5％,非糜烂型为22.7％、18.2％、22.7％),糜烂型的bcl-2表达阳性率明显高于非糜烂型(P<0.05)。45例OLP患者中有5例发生恶变,其AI明显低于未恶变者(P<0.01)。结论:细胞凋亡及凋亡相关基因P53、bcl-2、C-myc参与了OLP的发生发展,凋亡细胞较少且P53、bcl-2过度表达的OLP患者尤其是糜烂型应引起高度重视。

Objective: To study the effects of apoptosis and expression of apoptotic related genes P53@ bcl - 2@ C - myc on prognosis of oral lichen planus(OLP). Methods: Apoptotic cells and expression of P53, bcl-2, C -myc by TUNEL and im-munohistochemical method in 45 samples with OLP (23 cases of anabrotic OLP group and 22 cases of non - anabrotic OLP group). All the patients were followed up to Jan. 2001. Results: Apoptosis occured in all the cases and apoptotic index (AI) was 24.3% , AI of anabrotic OLP group(AI = 19. 0%) was markedly higher than that of non - anabrotic OLP group(AI = 29.4 % , P < 0.05). The positive rates of P53 @bcl - 2@C- myc expression were 31.3%, 35.6%, 33.3% respectively (those of anabrotic OLP were 39.1 % , 52.2 % , 43.5 % , and those of non - anabrotic OLP were 22.7 % , 18.2 % , 22.7 %), the positive rate of bcl - 2 expression in anabrotic group was signifcantly higher than that of non - anabrotic group ( P < 0.05). The cancer -ation occured in 5 cases with OLP,and AI of cancerous group was significancty lower than that of non - anabrotic group(P< 0.01), the positive rates of P53@bcl- 2 espression in cancerous group were obviouly higher than those of non - anabrotic group (P<0.01). Conclusion: Apoptosis and apoptotic related genes P53@bcl-2@ C - myc participate in clinical development of OLP. We should attach importance to less apoptotic cells and overexpression of P53@bcl - 2 in patients with OLP,especially anabrotic group.