CAJ | 학술논문

目的探讨细胞凋亡控制p53、bel-2和bax基因在眼眶泪腺腺样囊性癌中表达的作用及其临床意义.方法对天津医科大学二附属医院1962年1月至1998年1月收治的56例经手术及放疗联合治疗的眼眶泪腺腺样囊性癌资料进行回顾性分析,将其按疗效分为两组,5年内复发转移组32例和5年内无瘤生存组24例,观察其p53、bcl-2和bax基因蛋白表达情况,并以8名正常泪腺组织作为对照.结果 (1)p53在腺样囊性癌组的总表达阳性率为73.2%,其中复发转移组阳性率(81.3%,26/32)与无瘤生存组阳性率(62.5%,15/24),明显高于正常泪腺组织组(8例均为阴性)的表达率(均P<0.05);其中复发转移组阳性率明显高于无瘤生存组,其蛋白表达与临床预后呈负相关.(2)bcl-2在腺样囊性癌的总表达率为69.6%,其中复发转移组阳性率(18/32)与无瘤生存组阳性率(21/24),明显低于正常泪腺组织组(8例均为阳性)(P<0.05);复发转移组阳性率明显低于无瘤生存组,其蛋白表达与临床预后呈正相关.(3)bax在腺样囊性癌组的总表达阳性率为60.7%,总表达阳性率与正常泪腺组织组(1例为阴性,7例为阳性)比较差异无统计学意义(P>0.05).结论 p53、bcl-2和bax基因的表达均与临床预后密切相关,p53低表达和bel-2、bax的过表达临床预后较好,检测p53、bcl-2和bax可以作为判断眼眶泪腺腺样囊性癌临床预后的有价值的参考指标.
목적 탐토세포조망공제p53、bel-2화bax기인재안광루선선양낭성암중표체적작용급기림상의의.방법 대천진의과대학이부속의원1962년1월지1998년1월수치적56례경수술급방료연합치료적안광루선선양낭성암자료진행회고성분석,장기안료효분위량조,5년내복발전이조32례화5년내무류생존조24례,관찰기p53、bcl-2화bax기인단백표체정황,병이8명정상루선조직작위대조.결과 (1)p53재선양낭성암조적총표체양성솔위73.2%,기중복발전이조양성솔(81.3%,26/32)여무류생존조양성솔(62.5%,15/24),명현고우정상루선조직조(8례균위음성)적표체솔(균P<0.05);기중복발전이조양성솔명현고우무류생존조,기단백표체여림상예후정부상관.(2)bcl-2재선양낭성암적총표체솔위69.6%,기중복발전이조양성솔(18/32)여무류생존조양성솔(21/24),명현저우정상루선조직조(8례균위양성)(P<0.05);복발전이조양성솔명현저우무류생존조,기단백표체여림상예후정정상관.(3)bax재선양낭성암조적총표체양성솔위60.7%,총표체양성솔여정상루선조직조(1례위음성,7례위양성)비교차이무통계학의의(P>0.05).결론 p53、bcl-2화bax기인적표체균여림상예후밀절상관,p53저표체화bel-2、bax적과표체림상예후교호,검측p53、bcl-2화bax가이작위판단안광루선선양낭성암림상예후적유개치적삼고지표.
Objective To investigate the expression of p53,bcl-2,and bax,apoptosis regulating genes,in adenoid cystic carcinoma of larcrimal gland and the roles thereof in elinical prognosis.Methods 56 patients of adenoid cystic carcinoma of larerimal gland were divided into two groups according to the prognosis:poor prognosis group with recurrence or metastasis within 5 years(n=32)and better prognosis group(n=24)surviving tumor free within 5 years.The protein expression levels of p53,tumor suppressor gene,bax,apoptosis promoting gene,and bel-2,anti-apoptosis gene,were analyzed by strepavidin peroxidase method.8 cases of normal lacrimal gland tissues were used as controls.Results(1)The overall positive rate of p53 of the patients with adenoid cystic carcinoma of larcrimal gland was 73.2%.significantly higher than that of the normal controls(0,P<0.05).The p53 positive rate of better prognosis group waft 62.5%,significantly higher than that of the poor prognosis group(81.3%,P<0.05).The protein expression of p53 in adenoid cystic carcinoma of larerimal gland was negatively correlated with clinical prognosis.(2)The overall expression rate of bcl-2 of the patients with adenoid cystic carcinoma of larcrimal gland was 69.6%,significantly lower than that ofthe control group(P<0.05).The expression bel-2 protein was correlated with better clinical prognosis.(3)The bax positive rate of the patients with adenoid cystic carcinoma of larcrimal gland group was 60.7%.not significantly lower than the control group.The bax positive rate of the better prognosis group was 91.7%.significantly higher than that of the poor prognosis group(65.6%,P<0.05).Conclusion Some apoptosis regulating genes,such as mutation-type(mt)p53 play an important role in the gene ration and development of adenoid cystic carcinoma of larcrimal gland.p53,bax,and bel-2 proteins may act as valuable signals for clinical prognosis.The patients with over expression of bcl-2 and bax and low expression of p53 may have better prognosis than the contrary ones.