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为探讨细胞凋亡状态及其相关调控基因表达水平与人大肠癌演进的关系，作者分别采用ＦＣＭ检测短期原代培养的人大肠粘膜、腺瘤及癌细胞不同时相凋亡频率；ＴＵＮＥＬ技术检测２５例腺瘤和７７例腺癌组织中原位凋亡指数（ＡＩ）；免疫组化ＡＢＣ法检测原位增殖指数（ＫＩ）及ｂｃｌ－２、ｂａｘ、ｗａｆ１及ｐ５３基因表达。结果显示：体外培养癌细胞生长期凋亡频率明显低于粘膜细胞；体内瘤－癌组织中ＡＩ与ＫＩ相平衡；高分化和早期癌中ｂｃｌ－２呈高表达，癌前腺瘤、癌栓及远处转移病例中ＡＩ／ＫＩ增高并与ｂａｘ阳性表达和ｗａｆｌ缺失表达有一定联系，ｐ５３突变与高增殖水平有关。从而提示凋亡易感性改变可能在结直肠肿瘤形成早期起着重要作用；ＡＩ可能是一个反映增殖活性的指标；Ｂｃｌ家族基因与大肠癌细胞自发性凋亡及生物学行为有密切关系。
To explore the relationship between the apoptosis status and related regulatory gene expression levels and the evolution of human colorectal cancer, the authors used FCM to detect the apoptotic frequency of human colorectal mucosa, adenoma, and cancer cells at different phases in short-term primary culture; TUNEL assay In situ apoptotic index (AI) was detected in 25 cases of adenoma and 77 cases of adenocarcinoma. Immunohistochemical ABC method was used to detect the in situ proliferation index (KI) and the expression of bcl-2, bax, waf1 and p53 genes. The results showed that the apoptosis frequency of cancer cells in vitro was significantly lower than that of mucosal cells; the AI and KI balance in tumor-tumor tissues in vivo; the high expression of bcl-2 in high-differentiation and early cancer; precancerous adenoma and tumor thrombus. AI/KI increased in patients with distant metastases and was associated with bax-positive expression and wafl expression. p53 mutations were associated with high levels of proliferation. This suggests that changes in susceptibility to apoptosis may play an important role in the early stage of colorectal neoplasia; AI may be an indicator reflecting proliferative activity; Bcl family genes are closely related to the spontaneous apoptosis and biological behavior of colorectal cancer cells.