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目的 探讨凋亡相关基因p5 3、Bcl 2和Bax在口腔鳞状细胞癌发展各阶段的表达及意义。方法 采用免疫组织化学SP法检测 10例正常口腔粘膜上皮 ,48例异常增生上皮和 42例鳞癌组织中p5 3、Bcl 2和Bax的表达。结果 正常粘膜上皮中p5 3、Bcl 2、Bax影响表达率分别为 0 % ,2 0 %和6 0 % ;异常增生上皮组中 ,相对于正常组 ,p5 3阳性率明显提高 (P <0 0 5 ) ,Bcl 2表达无明显改变 (P >0 0 5 ) ,Bax阳性率亦无改变 (P >0 0 5 ) ,但染色强度随异常增生程度增加而增加 ;鳞癌组p5 3阳性率进一步提高 ,Bcl 2表达明显增强 ,Bax表达随组织学分级增加而下降。相关性分析显示 ,在异常组p5 3和Bax表达呈负相关 ,鳞癌组p5 3和Bcl 2表达显示正相关。结论 癌前病变中 ,p5 3突变导致异常增生上皮积累。鳞癌组织中 ,p5 3和抑凋亡基因Bcl 2作用加强 ,促凋亡因子Bax作用减弱 ,癌细胞凋亡受限 ,侵袭性增强。凋亡基因发挥作用有阶段性 ,它们既相互独立又相互协同 ,相互制约。
Objective To investigate the expression and significance of apoptosis-related genes p5 3, Bcl 2 and Bax in various stages of oral squamous cell carcinoma. Methods Immunohistochemical SP method was used to detect the expression of p53, Bcl 2 and Bax in 10 cases of normal oral mucosa epithelium, 48 cases of dysplastic epithelium and 42 cases of squamous cell carcinoma. Results The positive rates of p5 3, Bcl 2 and Bax in normal mucosal epithelium were 0%, 20% and 60%, respectively. The positive rate of p5 3 was significantly higher in the group of dysplasia than in the normal group (P <0 0) 5). There was no significant difference in the expression of Bcl 2 (P> 0.05) and the positive rate of Bax (P> 0.05), but the staining intensity increased with the degree of abnormal proliferation. The positive rate of p53 in squamous cell carcinoma The expression of Bcl 2 was significantly increased. The expression of Bax decreased with the increase of histological grade. Correlation analysis showed that there was a negative correlation between the expression of p5 3 and Bax in abnormal group, and the positive expression of p5 3 and Bcl 2 in squamous cell carcinoma. Conclusions In precancerous lesions, the mutation of p5 3 leads to the accumulation of dysplastic epithelium. In squamous cell carcinoma, the effect of p5 3 and Bcl-2 on apoptosis was enhanced, the effect of pro-apoptotic factor Bax was weakened, and the apoptosis of cancer cells was restricted and the invasion was enhanced. Apoptosis genes play a role in a phased manner, they are independent and mutually independent, mutual restraint.