胆囊癌组织survivin,caspase-3和Cox-2表达与临床病理特点的关系

Expression and clinicopathological relationship of survivin,caspase-3 and Cox-2 in gallbladder carcinoma

目的探讨survivin,caspase-3及Cox-2蛋白表达与胆囊癌生物学行为及临床病理指标的关系。方法检测4 9例胆囊癌、9例胆囊腺瘤、1 0例慢性胆囊炎组织中survivin,caspase-3及Cox-2的表达。结果(1)survivin,caspase-3及Cox-2在胆囊癌组织中阳性表达率分别为6 5.3%(3 2/4 9),4 4.9%(2 2/4 9)和7 5.5%(3 7/4 9),显著高于胆囊良性病变组织(分别为P<0.0 0 1,<0.0 0 1及=0.0 0 1)。(2)survivin表达与肿瘤浸润程度、分化程度、淋巴结转移及Nevin分期均无显著关系(均P>0.0 5);caspase-3表达与分化程度有关而与肿瘤浸润程度、淋巴结转移、Nevin分期无关;Cox-2阳性率在淋巴结转移组与非转移组、不同浸润深度以及Nevin分期间差异均有显著性,而与组织学分级无关。三者均与患者的年龄、性别无关。(3)survivin与caspase-3表达呈负相关(r=-0.3 7 3,P=0.0 0 8),survivin与Cox-2表达呈正相关(r=0.4 0 4,P=0.0 0 4),caspase-3与Cox-2表达无明显相关性(r=-0.1 5 6,P=0.2 8 4)。结论胆囊癌组织caspase-3表达较低,而survivin及Cox-2表达较高;survivin和Cox-2的过表达以及caspase-3的失表达在胆囊癌的发生、发展中起重要作用。survivin和Cox-2蛋白可望作为靶点用于胆囊癌靶向治疗。

Objective To evaluate the relationship between the expression of survivin, easpase-3 and Cox-2 and elinieopathologieal eharaeteristies in gallbladder eareinoma （GBC）. Methods Immunohistoehemistry was used to deteet the expression of survivin, easpase-3 and Cox-2 in 49 speeimens of GBCs, 9 cases of gallbladder adenoma and 10 eases of ehronie eholecystitis. Results Positive cytoplasmie immunoreaetivity was deteeted in a proportion of 65.3% for survivin, 44.9% for easpase-3, and 75.5% for Cox-2 in GBCs, respectively, and those were significantly higer in malignant lesions than in benign diseases. There was no significant relation between the expression of survivin or Caspase-3 and patients＇ clinicopathological features, except the expression of easpase-3 was related to the tumor differentiation. There was a relationship between Cox-2 expression and the depth of invasion, lymph node metastases and Nevin＇s staging of the tumor. Furthermore, the expression of survivin correlated positively with Cox-2 expression （ r = 0. 404, P = 0.004 ） and inversely with easpase-3 （ r = -0. 373, P = 0. 008 ） , but no significant correlation was found between the expression of caspase-3 and Cox-2 （ r = - 0. 156, P = 0. 284 ） . Conclusions The over-expression of survivin and Cox-2 and descended expression of easpase-3 play an important role in the carcinogenesis and progression of GBC. Survivin and Cox-2 may be identified as targets for target therapy of gallbladder carcinoma.