脑胶质瘤组织中survivin的表达与细胞凋亡和增殖的关系

Relationship between Survivin Gene Expression and Cell Proliferation or Apoptosis in Human Gliomas

检测Survivin在脑胶质瘤组织中的表达,探讨其与肿瘤细胞增殖、凋亡及预后的关系。方法:应用免疫组化SABC法分别检测Survivin、bcl-2和PCNA(细胞增殖活性标记物)的表达,并用TUNEL法做原位细胞凋亡检测,实验数据用SPSS 10.0软件包进行统计。结果:50例脑胶质瘤中Survivin表达的总阳性率为56%(28/50),高级别胶质瘤中Survivin的表达率(73.9%,17/23)比低级别胶质瘤(40.7%,11/27)显著增高(P<0.05);Survivin阳性表达和bcl-2的表达显著相关(P<0.01);Survivin表达的加权计分和PI呈正相关(P<0.01),和AI呈负相关(P<0.01)。PI和AI之间呈正相关(P<0.001)。Survivin阳性组与阴性组的术后1年生存率有显著差异(P<0.05)。多因素Logistic回归模型分析显示病理、Survivin、AI、PI和手术与预后相关(P<0.01)。结论:胶质瘤细胞survivin基因高表达可抑制细胞凋亡,促使细胞过度增殖,在胶质瘤发生、发展中起重要作用。肿瘤级别较低、Survivin阴性、AI<0.94%、PI<16.50%和手术全切的患者预后较好。

BACKGROUND & OBJECTIVES: Survivin is a newly identified member of the apoptosis family. This study was to investigate the relationship between the survivin gene expression level in human gliomas and the pathological grade, cell proliferative activity and apoptosis of the tumors. METHODS: Glioma specimens were obtained from 50 patients. Apoptotic cells and apoptotic bodies were detected by TUNEL. Immunohistochemi-cal stains were performed to examine the expression of Fas, Bcl-2, Survivin and PCNA. The software package SPSS 10.0 was used for statistical analysis. RESULTS: The percentage of positive survivin expression was 56% in the 50 specimens. The survivin-positive rate was significantly higher in high-grade tumors as compared with the low-grade tumors (73.9% versus 40.7%, P<0.05). Survivin expression was correlated with Bcl-2 expres-sion (P<0.01). Survivin weighted scores were negatively correlated (P<0. 01) with apoptosis index (AI) and were positively correlated (P<0. 01) with proliferation index (PI). There were significant positive linear correla-tions between AI and PI (P<0.001). The difference in one-year survival rate between survivin-positive and sur- vivin-negative group was statistically significant(50% versus 78. 9%; P<0. 05). Pathologi-cal grade, survivin, AI, PI and degree of surgi-cal resection were independently associated with prognosis of the patients with glioma when analyzed using logistic regression ( P< 0.01). CONCLUSION: Over-expression of survivin gene may inhibit apoptosis of glioma cells, and promote the excessive cell proliferation, both of which could play an important role in the development and malignant progres-sion of gliomas. Our results suggest the patients with low-grade tumor, negative for survivin, AI<0. 94%, PI<16. 50% and undergoing total surgical resection would have better prognosis.