肾细胞癌中bcl-2、p53、增殖细胞核抗原表达与细胞增殖和凋亡

Relationship between cell proliferation and apoptosis with bcl-2,p53,proliferating cell nuclear antigen expression in renal cell carcinoma

目的 探讨肾细胞癌 (RCC)中bcl 2、p5 3、增殖细胞核抗原 (PCNA)表达与细胞增殖、凋亡及病理参数之间的关系。方法 应用链霉亲和素辣根过氧化物酶 (SABC)法分析 3 4例RCC标本中bcl 2、p5 3和PCNA蛋白的表达 ,应用末端脱氧核苷酸转移酶介导的脱氧三磷酸尿苷(dUTP)缺口末端标记 (TUNEL)法检测细胞凋亡。结果 3 4例RCC标本中 ,15 ( 4 4.1% )例bcl 2阳性表达 ,表达阳性率与增殖指数 (PI)、凋亡指数 (AI)及RCC病理学参数无关 ;仅有 3例p5 3表达阳性 ;PI为 6.0 %～ 2 4.0 % (平均为 12 .3 % ) ,AI为 2 .0 %～ 8.0 % (平均为 5 .4% ) ;PI与肿瘤分级、分期密切关系 ,AI与肿瘤分级有明显关系。结论 明显增高的PI和AI与肿瘤恶性表型有关 ,提示在RCC中肿瘤细胞过度增殖伴有频繁的凋亡发生。

Objective To investigate the relaitonship between the immunohistochemical expression of bcl-2,p53,and proliferating cell nuclear antigen (PCNA) with cell propiferation,apoptosis in renal cell carcinoma (RCC).Methods Formalin-fixed and paraffin-embedded tissue blocks from 34 patients with RCC were studied.Immunoreactivity of bcl-2,p53 and PCNA were assessed immunohistochemically.Apoptosis was detected by terminal deoxy- nucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL).Results The expression of the bcl-2 protein was detected in 15 cases (44.1%),while that of the p53 protein was detectable in only 3 cases.bcl-2 positivity was not associated with any pathological parameters.The proliferative index (PI) ranged from 6.0% to 24.0% (mean 12.3%) and the apoptosis index (AI) from 2.0% to 8.0% (mean 5.4 %) in RCC.PI was closely associated with tumor grade and stage,and a significant relationship between AI and the tumor grade of RCC was seen.Conclusion Obviously increased PI and AI is correlated with the malignant phelotypes of tumors,suggesting active cell proliferation may be accompanied by frequent apoptosis in RCC.