凋亡相关基因survivin、bcl-2及caspase-3在胆囊癌中的表达及意义

目的探讨凋亡相关基因survivin、bcl-2及caspase-3在胆囊癌中的表达及其在胆囊癌发生、发展的可能作用及相互关系。方法应用免疫组织化学SABC法,检测39例胆囊癌组织、15例胆囊腺瘤组织和12例慢性胆囊炎组织中survivin、bcl-2及caspase-3表达情况,分析其与胆囊癌临床病理的关系,并探讨survivin、bcl-2及caspase-3表达在胆囊癌中的相关性。结果survivin在胆囊癌中的阳性表达率为71.8%,而在胆囊腺瘤及慢性胆囊炎中均无表达;bcl-2在胆囊癌中的表达阳性率为71.8%,而在胆囊腺瘤及慢性胆囊炎中均无表达;bcl-2在胆囊癌中的表达阳性率为38.5%,在胆囊腺瘤中为93.3%,在慢性胆囊炎中为8.3%,胆囊腺瘤bcl-2表达明显高于胆囊癌(P<0.01),胆囊癌bcl-2表达明显高于慢性胆囊炎组织(P<0.05)。caspase-3在胆囊癌中的表达阳性率为43.6%,胆囊腺瘤及慢性胆囊炎中caspase-3表达率均为100%。survivin表达与患者的临床病理无关。bcl-2及caspase-3的表达与胆囊癌患者的性别、年龄、肿瘤的大小无关,而阳性率在组织分化程度、不同Nevin分期组间差异有显著性(P<0.05)。survivin与bcl-2及caspase-3表达没有相关性(P>0.05),bcl-2与caspase-3表达具有良好的相关性(P<0.05)。结论survivin和bcl-2在胆囊癌中有较高表达,而caspase-3在胆囊癌中的表达下降;bcl-2与caspase-3可反映胆囊癌的某些临床病理特点;survivin、bcl-2及caspase-3共同调节胆囊癌细胞凋亡,进而影响胆囊癌的发生、发展。

Expression and Significance of Apoptosis Related Gene survivin,bcl-2 and caspase-3 in Gallbladder Carcinoma

Objective To investigate the expression of apoptosis related gene survivin,bcl-2 and caspase-3 in gallbladder carcinoma.Methods The expression of survivin,bcl-2 and caspase-3 protein in tissues from 39 cases of gallbladder carcinoma,15 cases of gallbladder adenocarcinoma and 12 cases of chronic cholecystitis were studied by SABC immunohistochemical assay,and their relations with clinicopathlogical features in gallbladder carcinoma were analyzed.The correlation analysis between the expression of the three genes were made.Results The positive expression rate of survivin protein was 71.8%(28/39) in gallbladder carcinoma,but there were no expression in benign gallbladder disease.The positive expression rate of bcl-2 protein was 38.5%(15/39) in gallbladder carcinoma,93.3%(14/15) in gallbladder adenocarcinoma and 8.3%(1/12) in chronic cholecystitis.The expression of bcl-2 protein in gallbladder adenocarcinom was higher than that in carcinoma(P<0.01),and the expression of bcl-2 protein in gallbladder carcinoma was higher than that in chronic cholecystitis(P<0.05).The positive expression rate of caspase-3 protein was 43.6%(17/39) in gallbladder carcinoma,100%(15/15) in gallbladder adenocarcinoma,and 100%(12/12) in chronic cholecystitis.The expression of caspase-3 protein in gallbladder carcinom was significantly lower than that in adenocarcinoma(P<0.01) and chronic cholecystitis(P<0.01).No correlation was found between the expression of survivin and clinicopathlogical features of the patients.No correlation was found between the expression of bcl-2 or caspase-3 and age,sex of the patients and the volume of the tumor,but there was significant difference between the expression of bcl-2 or caspase and the differentiation and the Nevin stage of the tumor(P<0.01).There was positive correlation between the expression of bcl-2 and that of caspase-3.Conclusion survivin,bcl-2 and caspase-3 all play an important role in the pathway of carcinogensis of gallbladder carcinoma,and survivin and bcl-2 may participate in apoptosis by regulating caspase-3.