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目的探讨细胞凋亡在乳腺癌变过程中的作用及其与细胞增殖以及ｂｃｌ２、ＰＣＮＡ表达的关系。方法利用ＴＵＮＥＬ法及ＳＰ免疫组化方法检测８１例乳腺癌及癌前病变中细胞凋亡发生率（ＡＩ）以及ｂｃｌ２、ＰＣＮＡ的表达；同时计算所有组织核分裂指数（ＭＩ）。结果正常乳腺上皮、增生性导管、原位癌及浸润性癌的ＡＩ和ＭＩ分别为：０１０％±０１２％、０３１％±０４３％、０４１％±０２１％、０７４％±０５６％和００２％±００５％、０１０％±０１６％、０２２％±０１７％、０５７％±０３５％（Ｐ＜００５）；ＡＩ与ＭＩ呈正相关（ｒ＝０８７，Ｐ＜００１），且随着病变的发展，ＡＩ／ＭＩ呈下降的趋势。正常乳腺上皮、增生性导管、原位癌、浸润性癌中ｂｃｌ２、ＰＣＮＡ表达率分别为：６８４２％、６２５０％、５５５６％、４８８９％和２６３２％、３７５０％、６６６７％、８８８９％；ＰＣＮＡ表达与ＭＩ呈正相关（ｒｓ＝１，Ｐ＜００１）。癌组织中，ｂｃｌ２高表达者ＡＩ显著低于ｂｃｌ２低表达者。结论细胞凋亡和细胞增殖均参与了乳腺癌变的过程，由于细胞丢失与细胞增殖水平的失衡，细胞增殖优势大于细胞凋亡，从?
Objective To investigate the role of apoptosis in breast cancer development and its relationship with cell proliferation and the expression of bcl-2 and PCNA. Methods The apoptosis rate (AI) and the expression of bcl2 and PCNA in 81 cases of breast cancer and precancerous lesions were detected by TUNEL method and SP immunohistochemical method. The nuclear splitting index (MI) of all tissues was also calculated. Results The AI and MI of normal breast epithelium, proliferative duct, carcinoma in situ, and invasive carcinoma were: 010%±012%, 031%±043%, 041%±0. 21%, 074%±056% and 002%±005%, 010%±016%, 022%±017%, 057%±0 35% (P<005); AI was positively correlated with MI (r=087, P<001), and with the development of lesions, AI/MI showed a tendency to decrease. The expression rates of bcl-2 and PCNA in normal breast epithelium, proliferative duct, carcinoma in situ, and invasive carcinoma were 6842%, 6250%, 5556%, 4889%, and 2632% respectively. , 3750%, 6667%, 8889%; PCNA expression was positively correlated with MI (rs=1, P<001). In cancer tissues, AI with high bcl-2 expression was significantly lower than those with low bcl-2 expression. Conclusions Both apoptosis and cell proliferation are involved in the process of breast cancer metastasis. Due to the imbalance of cell loss and cell proliferation, the cell proliferation advantage is greater than that of apoptosis.