Objective: To evaluate the relationship among cell proliferation, apoptosis, histological types and pathological grades in hepatocellular carcinoma. Methods: Apoptotic index (AI) were measured by the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick-end labeling (TUNEL), Ki-67, PCNA, p53, Bax,and Bcl-2 protein by strept avidin-biotin complex immunohistochemical technique in 57 cases HCC. Relationships among changes of these markers, histological types and pathological grades were analyzed. Results: Ki-67 protein expression of HCC cells in clear cell and trabecular pattern was significantly lower than that in solid, pseudoglandar and poorly differentiated pattern (P ＜0.05). Bcl-2 protein expression of HCC cells in pseudoglandar pattern was significantly lower than that in poorly or undifferentiated pattern (P ＜0.05). Bax protein expression of HCC cells in trabecular pattern was siginificantly higher than that in solid, poorly or undifferentiated and sclerosis pattern, and that in clear pattern was significantly higher than that in poorly or undifferentiated pattern (P ＜0.05). The ratio of Bcl-2to Bax protein expression of HCC cells in trabecular pattern was significantly lower than that in pseudoglandar,poorly or undifferentiated and sclerosis pattern, and that in clear pattern was significantly lower than that in poorly or undifferentiated pattern (P ＜0.05). Ki-67 and PCNA protein expressions of HCC cells significantly enhanced as grades increased. (P ＜0.05). Bax protein expression of HCC cells in Grade Ⅲ was significantly lower than that in grade Ⅱ (P ＜0.05). Apoptosis of HCC cells had significantly positive correlation with Bax protein expression, and significantly negative correlation with Ki-67 protein expression and the ratio of Bcl-2 and Bax protein expression (P ＜0.05). Ki-67 protein expression of HCC cells had significantly positive correlation with PCNA and P53 protein expression, and significantly negative correlation with Bax protein expression and apoptosis (P ＜0.05). PCNA protein expression of HCC cells had significantly positive correlation with Ki-67 and P53 protein expressions (P ＜0.05). P53protein expression of HCC cells had significantly positive correlation with Ki-67 and PCNA protein expression, and significantly negative correlation with the ratio of Bcl-2 and Bax protein expression (P ＜0.05). Bcl-2 protein expression of HCC cells had significantly positive correlation with the ratio of Bcl-2 and Bax protein expression and significantly negative correlation with PCNA protein expression (P ＜0.05). Bax protein expression of HCC cells had significantly positive correlation with apoptosis, and significantly negative correlation with Ki-67 and PCNA protein expressions, and the ratio of Bcl-2 and Bax protein expression (P ＜0.05). The ratio of Bcl-2 and Bax protein expression of HCC cells had significantly positive correlation with Bcl-2 protein expression, and significantly negative correlation with P53 and Bax protein expression and apoptosis (P ＜0.05). Conclusions: Apoptosis of HCC may have negative correlation with its proliferation, the apoptosis and cell proliferation of HCC existed discrepancy of histological types and pathological grades.%目的研究肝细胞癌细胞凋亡、细胞增殖及其与病理组织学类型的关系.方法经手术病理证实的6种组织学类型肝细胞癌57例,用TUNEL法检测凋亡细胞,用免疫组化检测各标本Bcl-2、Bax,P53,Ki-67和PCNA表达.结果透明细胞型和梁索型Ki-67蛋白表达较假腺样型、实体型和低(未)分化型低(P＜0.05).假腺样型Bcl-2蛋白较低(未)分化型低(P＜0.05);Bax蛋白表达梁索型较实体型、低(未)分化型和硬化型高(P＜0.05);透明细胞型较低(未)分化型高(P＜0.05).Bcl-2/Bax比值梁索型较假腺样型,硬化型和低(未)分化型低(P＜0.05);透明细胞型较低(未)分化型低(P＜0.05).随病理分级的升高Ki-67和PCNA蛋白表达升高(P＜0.05).3级Bax蛋白表达较2级显著降低(P＜0.05).细胞凋亡与Bax蛋白表达显著正相关,与Ki-67蛋白表达和Bcl-2/Bax蛋白表达比值显著负相关(P＜0.05).Ki-67蛋白表达与PCNA和P53蛋白表达显著正相关(P＜0.05),与细胞凋亡和Bax蛋白表达显著负相关(P＜0.05).P53蛋白表达与PCNA和Ki-67蛋白表达显著正相关(P＜0.05),与Bcl-2/Bax蛋白表达比值显著负相关(P＜0.05).Bcl-2蛋白表达与Bcl-2/Bax蛋白表达比值显著正相关(P＜0.05),与PCNA蛋白表达显著负相关(P＜0.05).Bax蛋白表达与细胞凋亡显著正相关(P＜0.05),与Ki-67、PCNA蛋白表达和Bcl-2/Bax蛋白表达比值显著负相关(P＜0.05).Bcl-2/Bax蛋白表达比值与Bcl-2蛋白表达显著正相关(P＜0.05),与细胞凋亡,P53和Bax蛋白表达显著负相关(P＜0.05).结论肝细胞癌凋亡和细胞增殖为负相关,两者均存在组织学类型和病理分级差异.
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