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Significance of Increased Apoptosis and Bax Expression in Human Small Intestinal Adenocarcinoma

Chun Gao and Ai-Ying Wang

Department of Gastroenterology, Peking University Third Hospital, Beijing, China (CG,AW), and Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China (CG)

Correspondence to: Dr. Ai-Ying Wang, MD, Department of Gastroenterology, Peking University Third Hospital, No. 49 Huayuan North Road, Beijing, 100191, People's Republic of China. E-mail: wangaiy{at}hsc.pku.edu.cn

Human small intestine accounts for 75% of the gastrointestinal (GI) length but for only 1–5% of GI tumors. The reason remains as yet unclearly understood. Our study was designed to examine whether increased apoptosis and expression of related genes/proteins, especially those of the Bcl-2 family, contribute to this difference. For this purpose, 77 samples from patients were examined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling and immunohistochemistry, including 40 cases from normal small intestine (jejunum), 7 cases from jejunum and ileum adenocarcinomas, and 30 cases from normal colon. The results showed that a significantly higher level of enterocyte apoptosis was observed in normal small intestine compared with small intestinal adenocarcinomas and normal colon (median of apoptotic index, 15.2% vs 0.1% and 1.6%, p<0.01). A similar pattern was observed for Bax (expression-positive, 77.5% vs 28.6% and 53.3%, p<0.05) but not for Bcl-2 (42.5% vs 42.9% and 46.7%, p>0.05) or Bax/Bcl-2 ratio (percent of samples having a ratio 1, 45.0% vs 14.3% and 36.7%, p>0.05). In conclusion, increased apoptosis and expression of Bax, not Bcl-2 or the Bax/Bcl-2 ratio, may play some role in the relatively lower incidence of human small intestinal carcinomas. However, more studies are required for a better understanding of these changes. (J Histochem Cytochem 57:1139–1148, 2009)

Key Words: small intestine • adenocarcinoma • apoptosis • Bax • Bax/Bcl-2 ratio

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