肝细胞癌survivin和caspase-3的表达及其与预后的关系

目的研究肝细胞癌（HCC）癌组织及癌旁组织survivin、caspase-3的表达及其与患者术后生存率之间的关系。方法免疫组织化学S-P法检测PCNA、survivin、caspase-3的表达,并以PCNA阳性强度计算增殖指数（PCNA-PI）,原位末端转移酶标记（TUNEL）法检测凋亡指数（AI）。结果survivin在肝细胞肝癌中表达阳性率高于癌旁组织（P〈0.05）。其阳性表达与肿瘤大小、肿瘤细胞分化程度、门静脉癌栓有关。癌组织中survivin表达阳性组的增殖指数PCNA-PI高于阴性组（P〈0.05）,凋亡指数低于阴性组（P〈0.05）。caspase-3在肝细胞癌中表达阳性率低于癌旁组织（P〈0.05）;其表达与肿瘤细胞分化程度和HBsAg有关。癌组织中caspase-3表达阳性组的增殖指数PCNA-PI低于阴性组（P〈0.05）,凋亡指数高于阴性组（P〈0.05）。在肝癌组织中survivin与caspase-3的表达呈负相关（r=-0.242,P〈0.05）。survivin阳性组患者生存率低于阴性组（P〈0.05）。caspase-3阴性组患者生存率低于阳性组（P〈0.05）。结论肝细胞癌组织survivin和caspase-3的表达影响癌细胞的增殖凋亡,对于判断HCC预后具有一定价值。

Relationship between expression of survivin and caspase-3 in human hepatocellular carcinoma and prognosis

Objective To investigate the expression of survivin and caspase-3 in the hepatocellular carcinoma（HCC） and the pericarcinomatous liver tissue,and to search the relationship between the expression and the patient survival rate after operation.Methods The expressions of PCNA survivin and caspase-3 were detected with immunohistochemistry.PCNA positive level was used to account proliferation index（PCNA-PI）.The apoptosis index of HCC tissues was detectde with TUNEL.Results The expression of survivin in HCC tissue was higher than that in paracancer tissue（P0.05）,which was related with portal vein thrombosis,tumor size and histologic differentiation（P0.05）.In HCC tissues,the PCNA-PI of the survivin positive group was higher than that of the negative group（P0.05）,and the AI of the survivin positive group was lower than that of the negative group（P0.05）.The expression of caspase-3 in HCC tissues was lower than that in paracancer tissues（P0.05）,which was related with HBsAg and histologic differentiation（P0.05）.In HCC tissues,the average PCNA-PI of the caspase-3 positive group was lower than that of the negative group（P0.05）,and the average AI of the caspase-3 positive group was higher than that of the negative group（P0.05）.There was negative correlation between the expressions of survivin and caspase-3 in HCC（r=-0.242,P0.05）.The survival rate of the survivin positive group was lower than that of the negative group（P0.05）,while that of the caspase-3 positive patients was higher than that of the negative ones（P0.05）.Conclusion The expression of survivin and caspase-3 in HCC can reflex the biological behavior of HCC and patients prognosis,which may be new target of tumor diagnosis and treatment.