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[摘要] 目的:探讨Bcl-2和ILK蛋白在子宫平滑肌肿瘤(USMTs)中的表达和意义。方法:对20例良性子宫平滑肌瘤(UL)、18例子宫平滑肌肉瘤(LMS)及70 例交界性子宫平滑肌瘤(BLM)[包括40例富于细胞型子宫平滑肌瘤(CL)、13例奇异型子宫平滑肌瘤(BL)、4例核分裂活跃型子宫平滑肌瘤(ML)、10例不典型子宫平滑肌瘤(AL)及3例恶性潜能未定型子宫平滑肌瘤(STUMP)]应用免疫组织化学法检测Bcl-2 和ILK蛋白的表达。结果:UL组Bcl-2蛋白表达阳性率明显高于LMS组(P 2 结果
20例UL中,ILK蛋白表达阳性4例(20%),Bcl-2蛋白表达阳性18例(90%);70例BLM中,ILK蛋白表达阳性24例(34.3%),Bcl-2蛋白表达阳性62例(88.6%);18例LMS中,ILK蛋白表达阳性15例(83.3%),Bcl-2蛋白表达阳性10例(55.6%)。UL组Bcl-2蛋白阳性表达率明显高于LMS组(P0.05)。见表1、2。
3 讨论
3.1 Bcl-2与USMT的关系
Bcl-2是一种抑制凋亡的线粒体内膜蛋白,与t(14、18)染色体易位有关,在程序性细胞凋亡中起十分重要的抑制作用[1]。该基因能延长细胞寿命,但不能促进细胞增殖[2]。研究表明,Bcl-2表达阳性率高的细胞寿命长,细胞凋亡进程缓慢,细胞堆积导致肿瘤的发生[3]。子宫平滑肌交界性肿瘤、子宫平滑肌肉瘤中细胞凋亡的速度明显慢于子宫肌瘤,致使含有异常DNA 的子宫平滑肌细胞不能正常进入细胞凋亡进程,导致恶性肿瘤的发生[4-7]。本组研究结果表明,UL组、BLM组Bcl-2蛋白表达阳性率明显高于LMS组(P0.05)。凋亡调控成为与恶性组织形成相关的基因改变的合适靶点。笔者的研究结果显示,Bcl-2和ILK的异常表达,通过抑制肿瘤细胞的凋亡对USMT的发生、发展起到重要作用。二者在LMS组与BLM组中差异有统计学意义,据此可以推测ILK与Bcl-2在LMS与BLM的鉴别诊断中有一定的辅助价值。
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(收稿日期:2010-02-22)
