ObjectiveTo observe apoptosis and proliferation of choledochus wall epithelial cell and fibrocyte, to understand the effects of apoptosis and proliferation on choledochal cyst development.MethodsThirty two cases of cystic dilatation,35 cases of cylindrical dilatation，and 25 cases of cholangiectasis caused by choledocholith were collected. All specimens were offered by department of hepatobiliarypediatric surgery. The apoptosis related index (bcl2 and bax) and cell proliferation index (PCNA) were detected by the immunohistochemical technique; Apoptosis was detected by TUNEL method. ResultsThere was serious mucosal epithelial cell damage in cystic dilatation group. In cylindrical dilatation group there was a damage similar to that of the cystis dilatation group, but the damage was not serious. In control group there was little damage in the duct wall, but there was a low positive rate of apoptosis of 〔epithelium cell (2.74±1.00)% and fibroblast (2.95±0.87）%〕, and a low bcl2 and bax’s expression rate, and a high PCNA’s expression rate 〔epithelium cell (3.74±1.00)%, fibroblast (3.71±1.77)%〕. There was no obvious difference between cylindrical dilatation group and cystic dilatation group (P gt;0.05): the PCNA’s expression rate was low 〔(0.99±0.51)% and (0.90±0.38)% respectively〕, the bax expression rate was high in remaining epithelial cell, and the positive rate of bax was apparently higher than that of bcl2 (P＜0.05), the positive rate of the apoptosis cell was high 〔(13.94±4.77)%, (7.51±3.46)%〕; the expression rate PCNA were high 〔(9.91±2.91)%,(9.70±3.18)%〕, and expression rate of bax’s was low in the fibre tissue, the positive rate of bcl2 was markedly higher than that of bax, and the positive rate of the apoptosis cell was low 〔(3.74±2.12)%,(4.46±2.41)%〕. There were no marked difference between the two groups (P gt;0.05). The expression of bcl2 and bax had marked difference both in cylindrical dilatation group and cystic dilatation group and as compared to control group (P＜0.05). ConclusionApoptosis has certain promoting effect in the course of choledochal cyst formation.
Citation：
ZHANG Aimin,LEI Zhengming,LI Jin,ZHI Yong,LONG Hanan. The Effects of Apoptosis and Proliferation on Choledochal Cyst. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2003, 10(1): 43-45. doi:
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- 1. 曾思务，刘雨，梁粉花，等. 胆囊病变时bcl2和p16蛋白产物的表达和意义 [J]. 中国普外基础与临床杂志， 1999; 6(2)∶26.
- 2. 刘战培，严律南. bcl蛋白在肝细胞肝癌发生过程中的表达及其与肝细胞凋亡变化的关系 [J]. 中国普外基础与临床杂志， 1999; 6(4)∶193.
- 3. 徐宏勇，李开宗，付由池，等. 人肝细胞癌中促凋亡基因bax的原位检测及其临床意义 [J]. 中国普外基础与临床杂志， 2000; 7(4)∶238.
- 4. 陈肖鸣，李仲荣，刘平. 近10年小儿胆总管囊肿诊治变迁（附79例报告） [J]. 中国普外基础与临床杂志， 1999; 6(3)∶90.
- 5. Todani T, Watanabe Y, Narusue M， et al. Congenital bile duct cysts: classification,operative procedures,and review of thirtyseven cases including cancer arising from choledochal cyst [J]. Am J Surg， 1977； 134（2）∶263.
- 6. Todani T,Watanabe Y，Fujii T, et al.Congenital choledochal cyst with intrahepatic involvement [J]. Arch Surg,1984； 119（9）∶1038.
- 7. 肖现民，周以明，陈莲，等. 囊形和梭形扩张症的比较观察和病因探讨 [J]. 肝胆外科杂志， 1998； 6（4）∶200.
- 8. Oltvai ZN,Milliman CL,Korsmeyer ST. Bcl2 heterodimerizes in vivo with a conserved homolog, Bax， that accelerates programmed cell death [J]. Cell, 1993； 74（4）∶609.
- 9. Wyllie AH. Apoptosis. Death gets a brake [J]. Nature， 1994； 369（6478）∶272.
- 10. Miyano T,Suruga K,Suda K.Abnormal choledochopancreatico ductal junction related to the etiology of infantile obstructive jaundice disease [J]. J Pediatr Surg, 1979； 14(1)∶16.
- 11. Hall PA, Levison DA,Woods AL, et al. Proliferating cell nuclear antigen(PCNA) immunolocalization in paraffin sections: an index of cell proliferation with evidence of deregulated expression in some neoplasms [J]. J Pathol， 1990； 162（4）∶285.
- 12. Jacobson MD,Burne JF,King MP, et al.Bcl2 blocks apoptosis in cells lacking mitochondrial DNA [J]. Nature, 1993; 361（6410）∶365.
- 13. 曾昭惠，杜琼,杨明清. 自由基氧化致线粒体DNA损伤与细胞凋亡 [J]. 国外医学临床生化与检验学分册， 1999; 20（4）∶167.
- 14. Li P,Nijhawan D,Budihardjo I, et al.Cytochrome c and dATPdependent formation of Apaf1/caspase9 complex initiates an apoptotic protease cascade [J]. Cell, 1997； 91（4）∶479.
- 15. Naga S. Apoptosis by death factor [J]. Cell, 1997； 88（3）∶355.
