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目的探讨凋亡相关基因easpase-9,bax和bel-2在大肠癌中的表达及其在大肠癌发生、发展中的可能作用及相互关系。方法应用免疫组化S-P法检测20例正常大肠黏膜、48例大肠腺瘤及56例大肠癌中的caspase-9、bax和bcl-2蛋白的表达。用TUNEL 法检测细胞凋亡。结果正常大肠黏膜、大肠腺瘤和大肠癌中caspase-9的阳性表达率分别为5．00％、33．33％、64．29％,其表达率在三者间差异有显著性(P<0．01)。bax在三种组织中的表达率分别为5．00％、35．42％、62．50％,三者间差异有显著性(P<0．01)。bcl-2 在三者中的阳性表达率分别为15．00％、87．50％、60．71％,三者间差异亦有显著性(P<0．01)。caspase-9,bax和bcl-2的表达与大肠癌的分化程度有关(P<0．01),与Dukes分期无关(P>05)。正常大肠黏膜、腺瘤和大肠癌中细胞凋亡指数差异有显著性(P<0．01),细胞凋亡指数与肿瘤的分化程度有关(P<0．01),与Dukes分期无关(P>0．05)。caspase-9、bax和bcl-2的表达与细胞凋亡指数有密切联系 (P<0．01)。结论肿瘤早期阶段的细胞凋亡异常,可能是大肠癌的发病原因之一。bcl-2和bax通过调节caspase-9参与大肠癌的发生。
Objective To investigate the expression of apoptosis-related genes, such as easpase-9, bax and bel-2, in colorectal cancer and its possible role in the development and progression of colorectal cancer. Methods The expressions of caspase-9, bax and bcl-2 in 20 cases of normal colorectal mucosa, 48 cases of colorectal adenoma and 56 cases of colorectal cancer were detected by immunohistochemical S-P method. Apoptosis was detected by TUNEL method. Results The positive rates of caspase-9 expression in normal colorectal mucosa, colorectal adenoma and colorectal cancer were 5.00%, 33.33%, 64.29%, respectively. The positive rates of caspase-9 expression were significantly different between the three groups (P < 0.01). The expression rates of bax in the three tissues were 5.00%, 35.42% and 62.50%, respectively, with significant difference (P <0.01). The positive rates of bcl-2 in the three groups were 15.00%, 87.50% and 60.71%, respectively. There was also a significant difference between the three groups (P <0.01). The expressions of caspase-9, bax and bcl-2 were correlated with the degree of differentiation of colorectal cancer (P <0.01), but not with Dukes stage (P> 0.05). The apoptosis index in normal colorectal mucosa, adenoma and colorectal cancer was significantly different (P <0.01). The apoptosis index was related to the differentiation of tumor (P <0.01), but not to the Dukes stage > 0.05). The expressions of caspase-9, bax and bcl-2 were closely related to the apoptosis index (P <0.01). Conclusion Abnormal apoptosis in the early stage of the tumor may be one of the causes of colorectal cancer. Bcl-2 and bax participate in the development of colorectal cancer by regulating caspase-9.