人肾透明细胞癌中ki-67 bcl-2 bax p53表达及癌细胞自发凋亡率的临床意义

Clinical significance of the expression of ki-67,bcl-2,bax,p53 and the spontaneous apoptosis in human renal clear cell carcinoma

目的 探讨人肾透明细胞癌中 ki- 6 7、bcl- 2、bax、p5 3表达及癌细胞自发凋亡率的临床意义。方法 选取 4 8例档存的肾透明细胞癌石蜡包埋标本 ,采用免疫组织化学方法检测癌细胞中 ki- 6 7、bcl- 2、bax、p5 3的表达 ,采用缺口末端标记法 ( TU NEL )检测癌细胞的自发凋亡率。结果 ki- 6 7表达率 ( PI)为 0 .15 %～ 36 .4 % ,随TNM分期的增高而增高。癌细胞自发凋亡率 ( AI)为 0 .2 %～ 15 .4 % ,随 TNM分期的增高有上升趋势。各因子之间关系分析 :1高 bax表达组的癌细胞凋亡率高 ;2 p5 3阴性组的 AI高 ,bax高 ,PI低 ;3未发现 bcl- 2与其他因子间有相关关系。预后分析 :PI、AI、p5 3、bax、bcl- 2 / bax、TNM是预后因素 ,PI、p5 3是独立预后因素。结论 细胞增生状态、细胞凋亡状态以及凋亡调控因子的表达情况是影响肾透明细胞癌发生。

Objective To assess the clinical significance of the expression of ki 67,bcl 2,bax,p53 protein and the spontaneous apoptosis in human renal clear cell carcinoma.Methods Immunohistochemical analysis of ki 67,bcl 2,bax,p53 was performed on paraffin embedded tissue sections from 48 human renal clear cell carcinomas.The terminal deoxynucleotidyl transferase mediated dUTP nick end labelling (TUNEL) was used to examine the apoptotic carcinoma cells.Results The expression rate of ki 67 was 0.15%～36.4% which positively correlated with tumor TNM stage.The tumor spontaneous apoptosis index (AI) was 0.2%～15.4% which had the increasing trend with the rising of TNM stage.High AI was associated with higher bax expression.p53 was negativity associated with higher AI and higher bax and lower ki 67 expression.The univariate analysis for disease specific survival showed that PI,AI,p53,bax,bcl 2/bax,TNM were prognostic parameters.Cox multivariate analysis revealed that PI,p53 were the independent prognostic parameters.Conclusion The state of proliferation,apoptosis and the expression of apoptotic regulators bcl 2,bax,p53 of cancer cells play a important role in the pathogenesis and development of the renal clear cell carcinoma.