大肠癌中survivin基因的表达及相关性研究

目的　探讨survivin凋亡抑制基因的表达变化与大肠癌生物学行为及cyclinD1、bcl 2、p5 3和凋亡指数 (AI)的相关性。方法　利用免疫组织化学EnVision法检测 98例大肠癌、2 4例正常大肠黏膜和 2 9例大肠息肉组织中survivin、bcl 2、cy clinD1,并用TUNEL法测定AI。结果　survivin、bcl 2、cyclinD1和 p5 3在 98例大肠癌组织中的阳性表达率分别为 6 8 37%、6 0 2 %、4 0 8%和 5 2 %。survivin表达在癌细胞胞质内 ,核内未见表达 ,bcl 2表达在细胞质内 ,cyclinD1和 p5 3均在核内表达。survivin的表达与组织学类型和淋巴结转移密切相关 (P均 <0 0 5 ) ,其阳性表达组的AI显著低于阴性组 (P <0 0 1) ,其阳性表达者术后 5年复发转移率均较阴性者显著增高 (P <0 0 1) ,而 5年生存率则显著降低 (P <0 0 5 ) ,survivin表达与bcl 2、p5 3无相关性 ,与cyclinD1表达呈正相关 (P <0 0 5 )。bcl 2和cyclinD1的阳性表达与组织学类型关系密切 (P均 <0 0 5 ) ,bcl 2阳性组的AI明显低于阴性组 (P <0 0 5 ) ,cyclinD1的阳性表达与 5年生存率明显相关 (P <0 0 5 )。 结论　survivin、bcl 2、cy clinD1和p5 3基因在大肠癌的发生、发展中起着不同程度的作用 ,它们的检测对大肠癌恶性程度的判定 ,预后分析和进一步治疗提

Expression of survivin gene in colorectal carcinoma and its significance

Purpose To study the relationship between survivin expression and the biological behavior, the expression of cyclinD1, bcl 2, p53 and apoptosis index ( AI ) in colorectal carcinoma. Methods The expression of survivin, cyclinD1, bcl 2, p53 and apoptosis was detected in 98 cases of the primary colorectal carcinoma, 24 cases of the normal tissue and 29 cases of colorectal polypus by using immunohistochemical EnVision and TUNEL method. Results The positive rates of survivin, cyclinD1, bcl 2 and p53 expression were 68 3%, 60 2%, 40 8% and 52%, respectively. Significant relationships were found between survivin, bcl 2 and cyclinD1 expressions and histological type of colorectal carcinoma( P <0 05). The mean AI in survivin and bcl 2 positive tumors was significant lower than that in survivin negative tumors ( P <0 01). The high level survivin and cyclinD1 expression was assocoated with the survival of less than 5 years ( P <0 05). Significant relationships were found between survivin, cyclinD1 expression and lymp node metastasis of colorectal carcinoma ( P <0 05). Conclusions This experiment suggests that survivin, bcl 2, p53 and cyclinD1 may play certain roles in the oncogenesis and progression of colorectal carcinoma. Detection of these gene products has positive effects on early diagnosis, malignancy determination, prognosis and treatment of colorectal carcinoma.