摘要目的 检测非小细胞肺癌(NSCLC)中ASPP1和ASPP2基因启动子CpG岛的甲基化状态和相应的蛋白表达,及癌细胞的凋亡水平和p53蛋白的表达,探讨ASPP基因在NSCLC中的作用及其临床意义.方法 采用甲基化特异性PCR(MSP)检测90例NSCLC组织、25例癌旁肺组织中ASPP1、ASPP2基因启动子的甲基化水平,并测序证实其甲基化位点;免疫组织化学EnVision法检测NSCLC组织中ASPP1、ASPP2和p53蛋白的表达;原位末端转移酶标记检测法(TUNEL)检测癌细胞凋亡,计算其凋亡指数(AI).结果 ASPP1基因启动子甲基化率在NSCLC中为42.2%(38/90),癌旁组织中为16.0%(4/25),二者比较差异有统计学意义(P=0.019);ASPP1基因启动子甲基化与患者年龄、性别、组织类型和分化程度无相关性(均P＞0.05),但与患者的TNM分期和淋巴结转移存在相关性(P=0.031,P=0.030);90例肺癌组织中ASPP1甲基化者其蛋白表达率明显低于ASPP1未甲基化者(P=0.002);ASPP1蛋白阳性组的AI值高于阴性组(P=0.022).90例NSCLC和25例癌旁组织中均未检测到ASPP2基因启动子甲基化;ASPP2蛋白表达阳性组和阴性组之间AI值差异也无统计学意义(P=0.282).ASPP1和p53表达呈负相关,(r=-0.259,P＜0.01),ASPP2和p53的表达状态无关(r=-0.119,P＞0.05).结论 NSCLC中ASPP1基因启动子甲基化可能是ASPP1蛋白表达下调的原因,高甲基化可能与NSCLC的恶性进展有关,ASPP1蛋白的表达能促进细胞凋亡.

abstractsObjective To investigate the methylation status of CpG islands in the promoter region and the protein expression of ASPP1 and ASPP2 genes in non-small-cell lung cancer (NSCLC) and their relationship with cellular apoptosis and p53 gene expression. Methods The 5'CpG island methylation patterns of ASPP1 and ASPP2 were evaluated by methylation specific polymerase chain reaction (MSP) followed by confirmation of sequencing. Immunohistochemistry was used to detect the expression of ASPP1,ASPP2 and p53 in lung carcinoma tissue samples ( n= 90) and adjacent non-neoplastic lung tissue samples (n = 25 ) . TUNEL assay was used to detect the apoptotic activity. Results The presence of ASPP1 methylation was significantly higher in NSCLC than that in the adjacent non-neoplastic lung tissue [42. 2%(38/90) vs. 16. 0% (4/25), P =0. 019]. ASPP1 promoter methylation had a close relationship with TNM stage and lymph node metastasis( P =0. 031, P =0. 030), but was not related to the age, sex, histological types and the grades of tumor differentiation (P =0. 389, P =0. 278, P =0. 570, and P =0. 103). Tumors with ASPP1 promoter methylation demonstrated a lower expression of ASPP1 as compared with those without the methylation (P =0. 002). ASPP1 expression was associated with a higher apoptotic index (AI) (P =0. 022) and a decreased p53 expression( r = -0. 259, P ＜ 0. 01 ). Methylation in the promoter region of ASPP2 gene was not detected in lung cancer (n = 90 ) or adjacent non-neoplastic lung tissue (n = 25 ).Expression of ASPP2 protein did not correlate with AI ( P = 0. 282 ) and p53 status in NSCLC. Conclusions High methylation of ASPP1 gene promoter regions is one of the important mechanisms that down-regulate its protein expression in NSCLC. ASPP1 promoter methylation may be associated with the malignant progression of the tumor, and ASPP1 expression promotes cellular apoptosis.