Survivin在胃腺癌、异型增生组织中的表达及其与p53、bcl-2的相关性

目的探讨凋亡抑制基因Survivin在胃癌、胃黏膜异型增生组织中的表达及其与突变型p53、bcl-2的相关性。方法应用免疫组织化学SP法检测50例胃腺癌组织、32例异型增生组织和20例正常胃黏膜组织中Survivin的表达。结果Survivin在正常胃黏膜组织、胃癌组织及轻、中、重度异型增生组织中的阳性表达率分别为0%、56%、9%、10%、54.5%,轻、中度异型增生组织中Survivin的阳性表达率明显低于重度异型增生和癌组织中的表达（P〈0.01）,而在重度异型增生和癌组织间无显著性差异（P均〉0.05）;Survivin的表达与胃癌的组织分化、浆膜侵犯、淋巴结转移、临床分期呈正相关（P〈0.05）,与年龄及肿瘤大小无相关性（P〉0.05）。结论（1）Survivin在胃癌及异型增生组织中呈异常表达,且该基因蛋白与胃癌的临床病理因素相关,提示Survivin在胃癌的发生发展中起重要作用;（2）在胃癌及异型增生组织中,Survivin的表达与p53、bcl-2基因蛋白存在相关性,提示3种基因蛋白可能在胃癌的发生、发展中起协同作用,联合检测Survivin、p53、bcl-2的表达,不仅有助于了解胃癌的发病机制,还可作为癌前或交界性病变发展演变的监测指标。

EXPRESSION OF SURVIVIN AND ITS RELATIONSHIP WITH P53, BCL-2 IN GASTRIC ADENOCARCINOMA AND DYSPLASIA

Objective To study the expression of survivin and its relationship with the expressions of p53 and bcl-2 in gastric adenocarcinoma and dysplasia.Methods The expressions of surviving,p53 and bcl-2 were measured by streptavidin-peroxidase immunohistochemistry in 50 cases of gastric adenocarcinoma,32 cases of dysplasia and 20 cases of normal gastric mucosa.Results The positive rates of survivin in gastric cancer,mild,moderate and severe atypical hyperplasia were 56%,9%,10%,54.5%,respectively,The positive rates of survivin in mild and moderate dysplasia were significantly lower than those in severe dysplasia and carcinoma,No significant difference was observed in survivin expression level between severe dysplasia and carcinoma（P〉 0.05）,There was a positive relationship between survivin gene with differentiation,clinical stages and lymph node metastases,and there was no association between surviving gene and patients＇ age,diameter of tumor（P〉0.05）,The positive expression of survivin in gastric cancer was related to the expressions of p53 and bcl-2（P〈0.05）.Conclusion（1） Abnormal expression of survivin protein in the gastric cancer and dysplasia and it＇s correlation with clinical pathological indexes indicate that survivin may play an important role in promoting tumorgenesis and progression of gastric cancer.Moreover,it can be taken as reference marker in diagnosis,grade,clinical stages of gastric cancer.（2） Expression of survivin in gastric cancer and dysplasia is associated with expressions of p53 and bcl-2 gene.Coexpressions of three proteins have the synergism in progression of gastric cancer.Therefore,detection of these marks will contribute to understanding pathogenesis of gastric cancer,and they can be taken as supervisory markers to reflect the development of precancerous and junction lesions.