大肠腺瘤和腺癌组织中Survivin的表达及其意义

Significance of Survivin expression in colorectal adenoma and adenocarcinoma

目的:研究Survivin在大肠腺瘤和腺癌组织中的表达及其意义。方法:SP法检测大肠腺瘤50例(管状腺瘤35例,绒毛状腺廇9例,混合腺廇6例)和大肠腺癌89例组织中Survivin表达情况,正常大肠黏膜组织20例作为对照。结果:在正常大肠黏膜组织、腺瘤和大肠腺癌中,Survivin的阳性表达率分别为10.0%(2/20)、26.0%(13/50)和75.3%(67/89);随腺瘤不典型增生程度增高,Survivin的表达也随之明显增高,P=0.019。Survivin的表达随大肠腺瘤分化程度的降低而升高[高、中和低分化组阳性表达率分别为65.0%(26/40)、86.0%(37/43)和100%(6/6)]。伴有淋巴结转移组大肠腺癌Survivin阳性表达率85.2%(52/61)明显高于无淋巴结转移组53.6%(15/28),P=0.003。在生存时间≥2年的大肠腺癌中,阳性表达率为73.7%(14/19),在<2年组中为64.7%(11/17),两者差异无统计学意义,P=0.41。结论:正常大肠黏膜、大肠腺瘤和大肠腺癌中Survivin的阳性表达逐步增高。随大肠腺瘤不典型增生程度增高,Survivin的表达也随之明显增高。Survivin的表达随大肠腺癌分化程度的降低而升高。伴有淋巴结转移组大肠腺癌Survivin表达的阳性率明显高于与无淋巴结转移组。

OBJECTIVE：To study the expression of Survivin protein in colorectal adenoma and adenocarcinoma. METHODS： SP immunohistochemical technique was used to assess the expression of Survivin at protein level in colorectal carcinoma and adenoma. Fifty cases of colorectal adenocarcinoma and 89 adenocarcinoma tissues embedded in paraffin were included in this study. Twenty normal colorectal mucossl tissues were the control group. RESULTS. The positive expression rates of Survivin in normal colorectal mucos,a, adenoma and adenocarcinoma cases were 10%（2/20）, 26. 0%（13/50） and 75. 3% （67/89） respectively. The immunohistochemical analysis of the Survivin expression in adenomas with different epithelial dysplasia showed that Survivin expression increased with the increasing of degree of epithelial dysplasiain adenoma, P=0. 019. Survivin expression in colorectal adenocareinoma was reversely related to pathological differentiation,and the expression increased when the differentiation decreased [the positive expression rates in well, moderate and poor differentiation group were 65. 0% （26/40）, 86. 0% （37/43） and 100%（6/6）, respectively]. The expression of Survivin in adenocarcinoma with lymph node metastasis was higher than that of without [85. 2%（52/61） vs 53. 6（15/28）, P=0. 003]. The positive Survivin expression rate was 73. 7%（14/19） in cases survived two or more than two years, while that was 64. 7%（11/17） in cases with survival less than 2 years,and no statistical significance was found, P = 0. 41. CONCLUSIONS： The positive Survivin expression in adenoma and adenocarcinoma is significantly higher than that in normal mucosa, while that of adencarcinoma is obviously higher than that of adenoma. Survivin expression increases with the increasing of degree of epithelial dysplasia in the adenoma. Survivin expression in colorectal adenocarcinoma is reversely related to pathological differentiation, the expression increases while the differentiation decreases. The expression of Survivin in adenocarcinoma with lymph node metastasis is higher than that of without.