Survivin在人结直肠腺瘤和腺癌组织中的表达

Expression of Survivin in Colorectal Adenoma and Adenocarcinoma

目的研究Survivin(SVV)在人结直肠腺瘤和腺癌组织中的表达及意义。方法采用免疫组织化学方法检测90例结直肠腺瘤、25例结直肠腺瘤伴重度不典型增生和108例结直肠腺癌组织中SVV、P53和Bcl-2的表达情况。结果SVV在结直肠腺管状腺瘤、绒毛状腺瘤、绒毛腺管状腺瘤等结直肠腺瘤组织中的表达率分别为30%(12/40)、40.9%(9/22)和35.8%(10/28),3组间差异无显著性(P>0.05)。SVV在绒毛腺管状腺瘤组织伴重度不典型增生组织,DukesA、B、C期结直肠腺癌组织中的表达率分别为68%(17/25)、75%(27/36)、81.3%(26/32)和95%(38/40),均明显高于结直肠腺瘤各组(P<0.05)。P53和Bcl-2在上述各组病例组织中的表达差异均无显著性(P>0.05)。SVV的高表达与Bcl-2和P53表达无相关性(P=0.487,P=0.437)。结论SVV在结直肠癌发生早期即有表达异常,可能与结直肠腺瘤癌变具有一定关系。SVV表达对结直肠腺瘤和腺癌的鉴别诊断具有一定意义。

Objective To explore the expression of Survivin （SVV） protein in colorectal carcinogen- esis and its clinical significance. Methods Immunohistochemistry staining was performed by two-step EnVision^TM technique for the paraffin sections, which included 90 adenomas, 25 ademomas with high-grade glandular intraepithelial neoplasia, and 108 colorectal adenocarcinomas. Results Expressions of SVV, P53, and Bcl-2 were observed in tumor cells of the sections. The positive rate of SVV in tubular adenomas, villous adenomas, and tubulovillous adenomas were 30% （12/40） , 40.9% （9/22）, and 35.8% （10/28） , respectively. The positive rate of SVV in tubulovillous adenomas with high-grade glandular intraepithelial neoplasia were 68% （17/25）. The positive rate of SVV in carcinomas of stage A, B, and C were 75% （27/36） , 81.3% （26/ 32） , and 95% （38/40） , respectively. SVV expressions among the three types of adenomas without neoplasia were not significantly different （ P 〉 0.05 ）. SVV expression between each type of the above-mentioned ademoma and tubulovillous adenoma with high-grade glandular intraepithelial neoplasia or different Dukes stages of colorectal carcinoma was significantly different （ P 〈 0. 05 ）. SVV expressions in adenocarcinomas and adenomas with high grade glandular intraepithelial neoplasia were significantly higher than those in adenomas （ P 〈 0. 01）. The expressions of P53 and Bcl-2 had no significant difference among them. No association was noted between SVV expression and P53 or Bcl-2 expression （ P = 0. 487, P = 0. 437）. Conclusions SVV is abnormally expressed in the early stage of colorectal carcinogenesis, which may be correlated with the carcinogenesis of colorectal ademoma. SVV expression may be useful to distinguish adenocarcinoma from adenoma in colorectal carcinogenesis.