| Background and Objective: Apoptosis may take some pole in the pathogenesis and development of laryngeal carcinoma. Bcl-2 , Bax and Bak protein take important poles in apoptosis. The expression of Bcl-2 and Bax and Bak protein were examined with immunohistochemical method in the experimentation, the relationship between the protein expression and the clinical features of laryngeal carcinoma, as well as the relationship among them were discussed. We could probe into the safe incisal range of removing laryngeal cancer determined from the albumen balance of cells to conduct our clinical work.Materials and Methods: The Paraffin-embeded specimens of 30 laryngeal squmous cell carcinoma(LSCC) patients underwent primary surgical resection from September. 2001 to Dcember, 2002. 27 patients were male and 3 were female. The age patients ranged from 39 to 74. Each patient' s specimens were ranged and studied in different regions of larynx including carcinoma, adjacent mucosa which was 2mm. 5mm and 10mm away from cancer. Ten normal laryngeal mucosa came from polyp of vocal cord. According to the criteria of UICC(1997) TNM classification, patients were assigned to the following groups: 6 were classified in Ti.l 1 in T2. 5 in T3.8 in T-4; and 19 patients were in No. 9 in Ni. 2 in N2; For different pathological grade. 14 patients were in Gi.ll in G2.5 inG3: For different growing place. 6 patients were in supraglottic portion .23 in glottic portion. 1 in infraglottic portion; and for clinical stage. 6 patients were in 1,10 in II. 6 in III,8 in I V. The Bcl-2,Bax and Bak were examined by immunohistochemical method of SP in these 30 laryngeal carcinoma patients and 10 polyp of vocal cord patients. Bcl-2.Bax and Bak oncoprotein was mainly expressed in cytoplasm of emithelium cells and cell membrances .appearing light yellow and high brown. For Bcl-2/Bax/Bak evaluation, the specimens were regarded as negative when less than 10% of tumor cells were stained.They were regarded as little positive when 10% -25% of them were stained, middle positive when 25%-50%,more positive when 50%-75%,most positive whenmore 15% of tumor cells. The relationships between the protein expression and laryngeal carcinoma' s clinical features.the relationships among them,as well as the relationships between carcinoma and carcinoma nearby were studied using statistical software(SPSS).Results: Bcl-2 oncoprotein was mainly expressed in cytoplasm of emithelium cells.and a small part of cell membrances were stained.Bax oncoprotein was expressed in cytoplasm and cell membrane.Both were appearing brown and yellow,granular distribution.Bax was less stained than Bcl-2.Bak oncoprotein was in cytoplasm ,with yellow -brown positive products. The positive expression percentages of Bcl-2, Bax and Bak oncoprotein were 73.33%,60% and 53.33%.The expression of them had obvious correlations with ages pathological grade.The expression of Bcl-2 was higher with younger age, lower pathological grade(P=0.037> P=0.007),but the expression of Bax and Bak was higher with older age and higher pathological grade (P=0.044, P=0.03; P=0.057, P=0.049) .The expression of Bcl-2 had also obvious correlations with T, clinical stage. All of them had not obvious correlations with sex,clinical place, metastasis of lymph node.The results also showed that the three proteins increased as tissue progressed in sequence from 10mm,5mm,2mm distant mucosa adjacent to carcinoma and carcinoma.A significant expression in most of them can be seen at regions of 5mm and 10mm distant from the tumor(P<0.05).Conclusion:Bcl-2 was restraining apoptosis gene, Bax ,Bak were promoting apoptosis gene.Bcl-2,Bax,Bak may act as a reference index in judging the biological speciality of LSCC.Higher Bcl-2 was with lower Bax or Bak,the imbalance of restraining or promoting apoptosis of Bcl-2 and Bax may play an important role in LSCC. It is appropriate to regard 10mm away from tumors as the resection margins for surgical treatment of laryngeal carcinoma.YOU Longgui (Otolaryngology) Directed by Profe...
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