肝癌组织survivin的表达与凋亡,增殖和p53的关系

目的：研究肝癌survivin的表达与细胞增殖、凋亡以及053表达的关系．方法：应用免疫组化法检测原发性肝癌组织42例、癌旁肝硬化组织34例、正常肝组织10例中survivin，p53，增殖细胞核抗原（PCNA）的表达．应用TUNEL法检测细胞凋亡．结果：在42例肝癌组织中survivin阳性30例（71．4％），显著高于癌旁肝硬化组织（11．8％）和正常肝组织（0％，P〈0．001）．肝癌中survivin蛋白的高表达与病理分级（P=0．003），p53蛋白水平（P=0．008）、细胞增殖凋亡比（P=0．001）及患者生存时间（P=0．002）存在显著相关性，而与年龄、性别、肿瘤大小、临床分期、门脉癌栓（局部转移）无显著相关（P〉0．05）．结论：肝癌组织survivin高表达在打破肝癌细胞的增生和凋亡之间的平衡中起着重要作用．Survivin可能抑制p53阴性肝癌细胞的凋亡，在肿瘤细胞的进一步恶性转化中发挥作用．

Relationships between survivin expression and cancer cell apoptosis, proliferation and p53 expression in hepatocellular carcinoma

AIM: To investigate the expression of survivin protein and its relationship with cell apoptosis, proliferation and p53 protein expression in primary hepatocellular carcinoma (HCC). METHODS: The expressions of survivin, p53 and proliferating cell nuclear antigen (PCNA) in 42 cancer tissues, 34 ajacent cirrhosis tissues and 10 normal tissues were assessed by immunohistochemical method and apoptosis was detected by TUNEL method. RESULTS: Survivin protein was expressed in 30 of the 42 cases of HCC (71.4%) and in 4 of the 34 cases of adjacent cirrhosis tissues (11.8%). Expression of survivin protein was negative in the 10 cases of normal tissues. Survivin protein positive expression rate in HCC was significantly higher than that in adjacent cirrhosis tissues and normal tissues (P<0.001). The increased survivin protein expression in cancer was significantly correlated with the histological grade (P=0.003), p53 protein expression (P=0.008), survival time (P=0.002) and the ratio of proliferative index to apoptotic index (P=0.001), but was not with age, sex, tumor size, clinical stage and local metastasis (P>0.05). CONCLUSION: There is a marked increased survivin expression in HCC, which may play an important role in breaking the balance between the proliferation and apoptosis of HCC cells. Survivin may promote p53-negative HCC cells to obtain an anti-apoptosis ability, thereby promoting the development of HCC and partly playing a role in the further malignant transition of tumor cells.