Caspase-9和Survivin在肝癌组织中的表达及意义

目的探讨Caspase-9和Survivin在肝细胞癌(HCC)患者肝癌组织中的表达及其临床意义。方法应用免疫组织化学SP法检测92例肝癌患者肝癌组织及其对应癌旁正常肝组织中Caspase-9和Survivin的表达,并分析其表达与HCC临床恶性生物学行为的相关性。组间比较采用卡方检验,相关性分析采用Spearman等级相关法。结果 Caspase-9在肝癌组织中的表达明显低于癌旁组织,而Survivin在肝癌组织中的表达明显高于癌旁组织,差异均具有统计学意义(χ2=6.48、7.05,P0.05)。在TNM分期Ⅲ~Ⅳ期、门静脉癌栓、淋巴结转移的肝癌组织中Survivin的阳性表达率明显增高(χ2=5.07、6.18、8.29,P0.05),而在其他分组中比较差异无统计学意义;在病理分级Ⅲ~Ⅳ级的肝癌组织中Caspase-9的阳性表达率明显降低(χ2=7.63,P0.05),而在其他分组中比较差异无统计学意义。结论 Caspase-9低表达和Survivin异常高表达均参与肝癌的发生过程,Caspase-9低表达可能与肝癌细胞恶性分化密切相关,而Survivin高表达与肝癌的浸润或远处转移等恶性发展密切相关。

Expression of Caspase -9 and Survivin in hepatocellular carcinoma tissues and its clinical significance

Objective To investigate the expression of Caspase - 9 and Survivin in hepatocellular carcinoma＇（ HCC ） tissues and its clinical significance. Methods The immunohistochemical SP method was used to measure the expression of Caspase -9 and Survivin in the HCC tissues and paracancerous normal liver tissues of 92 HCC patients, and the relationship between their expression and the clinical malignant biological behavior of HCC was analyzed. Results Compared with paracancerous normal liver tissues, the HCC tissues had significantly lower expression of Caspase - 9 （X^2 = 6.48, P 〈 0.05 ） and significantly higher expression of Survivin （,X^2 = 7.05, P 〈 0.05 ）. The positiye rate of Survivin in HCC tissues was significantly higher in patients with TNM stageⅢ-Ⅳ disease, with portal vein tumor thrombus （PVTF）, and with lymph node metastasis （LNM） than in those with TNM stage Ⅰ -Ⅱ disease, without PVTY, and without LNM （X^2 = 5.07, P 〈 0. 05;X2 = 6. 18, P 〈 0. 05;Xz = 8.29, P 〈 0.05 ）, but no significant differences were found between other group pairs. The positive rate of Caspase - 9 in HCC tissues was significantly lower in patients with pathological stage Ⅲ-ⅣV disease than in those with patho- logical stage I - II disease （X^2 = 7.63, P 〈 0.05 ）, but no significant differences were found between other group pairs. Conclusion Low expression of Caspase - 9 and abnormally high expression of Snrvivin were both involved in the development of HCC. Low expression of Caspase -9 may be closely associated with the malignant differentiation of HCC cells, and high expression of Survivin is closely associated with the malignant progression, such as invasion and distant metastasis, of HCC.