胃肠间质瘤中survivin、ki-67、bcl-2蛋白的表达及意义

Expression of Survivin,ki-67 and bcl-2 in Gastrointestinal Stromal Tumors and Its Clinical Implication

目的探讨survivin、ki-67以及bcl-2蛋白在胃肠道间质瘤(GIST)中的表达情况及临床意义。方法采用免疫组化SP法检测78例胃肠道间质瘤组织中survivin、ki-67以及bcl-2蛋白的表达,并统计分析其在不同性质的GIST中的表达差异。结果78例GIST中,survivn、ki-67以及bcl-2蛋白的阳性表达率分别为69.2%、38.5%和60.2%。survivin,ki-67蛋白在良性、交界性、恶性GIST中的表达有显著差异(P<0.05),而bcl-2在不同性质肿瘤中表达无显著差异(P>0.05)。在GIST肿瘤组织中survivin与ki-67表达强度具有显著的正相关(rS′=0.83);survivin与bcl-2阳性表达程度有一定的相关性(rS′=0.57);ki-67表达强度与核分裂记数呈明显的正相关(rS′=0.91)。结论survivin、ki-67、bcl-2在胃肠道间质瘤的发病机制中具有重要作用,surivin和ki-67蛋白的表达率的高低对判断GIST的性质具有重要意义,但bcl-2尚不能作为判断良恶性的指标。

Objective To investigate the expression of survivin, ki-67,and bcl-2 protein in gastrointestinal stromal tumors （GIST） and its clinical significance. Methods The expression of survivin,ki-67 and bcl-2 protein were detected in 78 cases of GIST by immunohistochemical technique. The relationship between expression of survivin, ki-67, bcl-2 protein and the clinicopathological factors of GIST was analyzed. Results The positive expression rate of survivin, ki-67 and bcl-2 protein in GIST was 69.2% ,38.5% and 60. 2% respectively,The difference of positive expression rate of survivin and ki-67 protein was significant among benign, borderline and malignant GISTs （ P 〈 0.05 ）. The positive expression rate of bcl-2 protein was not different among the groups（ P 〉 0.05 ）. There was significant correlation between survivin and ki-67 （r s＇ = 0.83 ）. There was partly correlation between survivin and bcl-2 （rs＇ = 0. 57） in 78 cases of GIST and There was significant correlation between ki-67 and the mitotic index（ rs＇ = 0. 91 ） in these cases. Conclusion survivin,ki-67 and bcl-2 play important role in the pathogenesis of GIST. The expression of survivin and ki-67 protein are important predicting marker for differentiation degree of GIST, but bcl-2 protein is not.