Survivin、fhit在结直肠良恶性病变中的表达及意义

Expression and Significance of Survivin and Fhit Protein in Colorectal Benign and Malignant Disease.

目的探讨survivin蛋白、fhit蛋白在结直肠良性和恶性病变中的表达及意义。方法采用免疫组化S-P法检测20例正常结肠黏膜、30例结直肠低级别上皮内瘤变、30例结肠高级别上皮内瘤变、68例结直肠癌组织中survivin、fhit的表达。结果Survivin在正常结肠黏膜中无表达,在低级别上皮内瘤变、高级别上皮内瘤变及腺癌中的阳性表达分别为43.3%、76.7%、91.2%,正常结肠黏膜与高级别上皮内瘤变、腺癌相比,差异有显著性(P<0.01)。fhit在结直肠腺癌中的阳性率明显低于正常结肠黏膜或结肠上皮内瘤变,差异有显著性(P<0.01)。在结直肠癌组织中,随组织学分级的增加、Dukes分期的进展和淋巴结的转移,survivin表达阳性率逐渐上升,fhit表达阳性率逐渐下降,差异有显著性(P<0.05),survivin和fhit表达呈负相关性(r=-0.527,P=0.000)。结论Survin和Fhit基因突变或缺失在结直肠癌的发生发展中可能起重要作用,Survin和Fhit联合检测有助于结直肠肿瘤的早期诊断、早期治疗及生物学行为的评估。

Objective To investigate the expression and significance of Survivin and Fhit protein in colorectal benign and malignant disease. Methods Test the expression of Survivin and Fhit proteins in 20 cases normal colorectal mucosa, 30 cases low grade colorectal intraepithelial lesion, 30 cases high grade colorectal intraepithelial lesion and 68 cases colorectal adenocarcinoma by immunohistochemical staining S - P method. Results The unexpression of Survivin in normal colorectal mucosa, postive expression rates of Survivin in low grade colorectal intraepithelial lesion, high grade colorectal intraepithelial lision and colorectal adenocarcinoma were 43.3% , 76.7% and 91.2% （P 〈 0. 01 ） differently; The positive expression rate of Fhit in colorectal adenocarcinoma was lower than that in normal colorectal mucosa or colorectal intraepithelial lesion（P 〈0.01 ）;With the increase of histological grade, development of Dukes phase and lymph node metastasis of colorectal carcinoma, the expression rate of Survivin was increased, while the expression rate of Fhit was decreased. Negative correlation was also found between Survivin and Fhit expression （ r = - 0. 527, P = 0. 000 ）. Conclusions Survivin may promote matastasis, and affect prognosis of colorectal carcinoma through inhibiting cell apoptosis. Survivin and Fhit gene mutation or deletion may be mainly involved in the development and invasion of colorectal tumors. Examination of Survivin and Fhit protein will be helpful to early diagnosis and treatment of colorectal carcinoma and evaluation of its biologic behavior.