Survivin和p53在胃粘膜异型增生和胃癌中的表达及其临床意义

目的探讨survivin和p53表达在胃粘膜上皮癌变过程中的作用.方法采用免疫组织化学SP法检测80例胃癌、88例胃粘膜异型增生和22例正常胃粘膜中survivin、p53的表达,分析它们与胃癌临床病理特征的关系.结果(1)survivin在正常胃粘膜不表达.survivin阳性表达率在轻中度异型增生时较低,分别是3%(1/28)和7%(3/43);而在重度异型增生时达82%(14/17),与胃癌组76%(61/80)无显著差异(P＞0.05).p53在正常胃粘膜和轻度异型增生无表达,中度异型增生时有少量表达16%7/43,至重度异型增生时阳性表达率达35%6/17,与胃癌组52%42/80无显著差异(P＞0.05);(2)survivin表达与胃癌不同分化程度、浸润深度无关,与淋巴结转移有关.p53表达与胃癌不同分化程度、浸润深度和淋巴结转移有关;(3)survivin和p53表达呈正相关(P＜0.01).结论survivin和p53共同参与胃癌的发生过程,是胃癌早期诊断的有用指标.p53亦可作为反映胃癌生物学行为的依据之一.

Experssion of Survivin and p53 in Gastric Epithelial Dysplasia and Gastric Carcinoma

Objective: To investigate the expression of survivin and p53 in gastric epithelial dysplasia and gastric carcinoma. Methods: The expression of survivin and p53 were detected in 190 cases of gastric specimens by immunohistochemical technique. Results: (1) survivin was negatively expressed in normal gastric mucosa. The positive expression rates of survivin in mild,moderate and severe dysplasia were 3%, 7% and 82%, respectively. There was no significant difference between severe dysplasia and gastric carcinoma (P>0. 05). There was no positive expression of p53 in normal gastric mucosa and mild dysplasia,the positive expression rates of p51 in moderate and severe dysplasia were 16% and 35%, respectively. There was no significance difference between severe dysplasia and gastric carcinoma (P>0. 05). (2)The expression of survivin was not related to the differential degree and the invasive depth of gastric carcinoma. Significant relationship was found between survivin expression and lymph node metastasis. Significant relationships were found between p53 expression and the differential degree, the invasive depth of gastric carcinoma or lymph node metastasis. (3)There was a positive correlation between the expression of survivin and p53. Conclusion: Survivin and p53 may play certain roles in the carcinogenesis and contribute to early diagnosis of gastric carcinoma. p53 may serve as a useful marker for evaluation of the biological behavior of tumor.