Survivin和PTEN蛋白在宫颈鳞状细胞癌中的表达及临床意义

目的：探讨凋亡抑制基因蛋白Survivin与抑癌基因蛋白PTEN在宫颈癌前病变和宫颈鳞状细胞癌组织中的表达及其两者的相关性。方法：选取93例慢性宫颈炎、宫颈糜烂伴鳞化（慢鳞）、宫颈上皮内瘤变（CIN）及宫颈鳞状细胞癌患者，另取10例正常宫颈组织作为对照。应用免疫组化S-P法检测各组宫颈组织中Survivin和PTEN蛋白的表达。结果：（1）从慢鳞-上皮内瘤变-宫颈鳞状细胞癌，Survivin的表达逐渐增强（P〈0．01），而PTEN的表达逐渐减弱（P〈0．01）；（2）Survivin的表达与宫颈癌组织学分级、浸润深度、临床分期有关（P〈0．05），而与年龄无关（P〉0．05）；PTEN蛋白的表达与宫颈癌浸润深度、临床分期有关（P〈0．05），而与年龄、组织学分级无关（P〉0、05）；（3）Survivin与PTEN蛋白的表达在CIN、宫颈鳞状细胞癌组织中的表达呈显著负相关（P〈0．01），而且在宫颈癌中的表达相关性更为密切。结论：Survivin的异常高表达与PTEN的异常低表达参与了宫颈癌的发生、发展，与凋亡抑制和增殖能力增强有关；发生在宫颈癌恶性转化的早期，并且其表达程度可作为预后不良的标志。

Expression and clinical significance of survivin and PTEN in specimens of cervical carcinoma

Objective:The purpose of this study is to examine the expression and the relationship of apoptosis inhibition factor survivin and carcinoma-inhibiting protein PTEN in cervical cancer and precancerous tissues.Methods:There were 93 patients with chronic cervicitis and cervical erosion of metaplasia(CCM),cervical intraepithelial neoplasia(CIN)and cervical carcinoma,and another 10 cases of normal cervical specimens were selected as the control.The expression levels of apoptosis inhibition factor survivin and carcinoma-inhibiting protein PTEN were tested by immunohistochemistry.Results:(1)From CCM to tumor progression,cervix cancer,survivin expression tends to increase ment(P<0.01);the expression of PTEN tends to decrease ment(P<0.01).(2)Survivin was related with the patients' infiltration,depth,clinical stages(P<0.05),but not related with the patients' ages or histological grade of invasive carcinoma(P>0.05).(3)The expression of survivin and PTEN was extremely negatively correlated in CIN and cervical carcinoma(P<0.01)and highly related in cervical carcinoma.Conclusion:The abnormal high expression of survivin and abnormal low expression of PTEN in cervical carcinoma may be involved in the occurrence and development of cervical carcinoma,may be related with the cell apoptosis and proliferation,they occur in the early period of cervical carcinoma transformation,and higher levels of survivin and lower levels of PTEN may indicate infausta prognosis for patients with cervical carcinomas.