食管鳞癌组织中Livin和Smac表达的意义

目的探讨食管鳞癌组织中凋亡抑制蛋白Livin和促凋亡基因Smac蛋白的表达及其与食管鳞癌临床生物学指标的关系。方法应用免疫组化SP法对62例食管鳞癌组织、31例癌旁不典型增生组织及62例正常食管黏膜组织进行Livin和Smac蛋白的检测，分析其阳性表达与食管鳞癌患者临床病理因素的关系。结果62例食管鳞癌组织中，组织学分级Ⅰ级15例、Ⅱ级25例、Ⅲ级22例；有淋巴结转移20例；肿瘤浸润至黏膜层、黏膜下层或浅肌层7例、深肌层14例、纤维膜41例。Livin蛋白在正常食管黏膜组织中低表达，在癌旁不典型增生组织及食管鳞癌组织中高表达，阳性率分别为38.7%（24/62）、61.3%（19/31）和80.6%（50/62），差异有统计学意义（χ2=22.742，P<0.05）；Smac蛋白在癌旁不典型增生组织中高表达，在正常食管黏膜组织及食管鳞癌组织中低表达，阳性率分别为67.7%（21/31）、48.4%（30/62）和33.9%（21/62），差异也有统计学意义（χ2=9.688，P<0.05）。食管鳞癌患者癌组织中Livin和Smac蛋白的表达与性别、年龄无关；与组织学分级、浸润深度及有无淋巴结转移有关（P<0.05）。Livin和Smac蛋白在食管鳞癌组织中的表达呈负相关（r=－0.426，P<0.05）。结论Livin和Smac在食管鳞癌组织中呈现异常表达，提示两者参与了食管鳞癌的发生发展和浸润转移。

Expression and Clinical Significance of Livin and Smac in Human Esophageal Squamous Cell Carcinoma

Objective To investigate the expression of Livin and Smac proteins in esophageal squamous cell carcinoma (ESCC) tissue and their relationship to the progression of ESCC.MethodsExpressions of Livin and Smac proteins were respectively detected by immunohistochemistry SP method in 62 cases of ESCC, in 31 cases of paracancerous atypical hyperplasia, and in 62 cases of normal esophageal mucosa. Then the relationships between Livin and Smac protein expressions and clinicopathologic features of ESCC patients were estimated.ResultsOf the 62 ESCC patients, ther diagnosis of ESCC were confirmed by histopathological detection, 15 cases were grade Ⅰ, 25 cases were grade Ⅱ, 22 cases were grade Ⅲ; 20 cases have lymph node metastasis; and 7 cases were followed with invasion of mucosa, submucosa, or shallow layer, 14 cases have invasion of deep muscle, 41 cases have invasion of fiber membrane. Livin protein were lower expressed in normal esophageal mucosa, but high expressed in paracancerous dysplasia and esophageal cancer tissues, and the difference among the 3 groups was statistically significant (χ2=22.742，P<0.05). Smac protein were overexpressed in paracancerous dysplasia, but less expressed in normal esophageal mucosa and esophageal cancer tissues, and the difference among the 3 groups was statistically significant (χ2=9.688,P<0.05). Livin and Smac protein expressions in ESCC tissues were not affected by the patients’ gender and age, however it was significantly correlated with the histological grade, depth of invasion or lymph node metastases (P<0.05). The expression of Livin and Smac proteins was negatively correlated with the progression of ESSC （r=－0.426，P<0.05）.ConclusionAbnormal expression of Livin and Smac occured in ESCC, which suggested that Livin and Smac play important role in the development, invasion and metastasis of ESCC.