Survivin、Caspase-3和Bcl-2在肺癌中的表达及意义

Expression of Survivin,Caspase-3 and Bcl-2 in lung carcinoma

背景与目的:细胞凋亡异常是肿瘤发生的原因之一。细胞凋亡是受凋亡控制基因调节,近来研究表明由于肿瘤组织分型不同,其凋亡调控基因的表达也存在差异。本研究旨在通过和细胞凋亡有关的基因蛋白生存素(Survivin)、Caspase-3和Bcl-2在小细胞肺癌(small cell lung cancer,SCLC)与非小细胞肺癌(non-small cell lung cancer,NSCLC)中的表达分布,对同一肿瘤,不同病理类型组织肺癌进行凋亡对比性研究,描述性分析在同一解剖部位、不同细胞学类型肿瘤组织中三种有关凋亡的基因蛋白表达的差异。方法:选取41例SCLC,30例NSCLC,采用免疫组化SP法检测肺癌组织中Survivin、Caspase-3、Bcl-2的表达水平和相关性。结果:SCLC中Survivin阳性表达率为29.3%,NSCLC为70%,两者表达分布差异有显著性(P<0.01);SCLC中Bcl-2阳性表达率为63.4%,NSCLC为30%,两者表达分布差异有显著性(P<0.05);SCLC的Survivin阳性患者中Caspase-3表达率为3/12例,阴性患者为62.1%(18/29),两者间差异有显著性(χ2=4.67,P<0.05)。NSCLC中Survivin阳性患者中Caspase-3的表达率为19.0%(4/21),阴性患者为88.9%(8/9),阴性患者Caspase-3的表达率显著高于阳性患者(χ2=12.80,P<0.01)。Caspase-3阳性表达在SCLC和NSCLC的表达分别为51.2%和40.0%,差异无显著性(P>0.05)。结论:在NSCLC中,Survivin表达上调,Bcl-2表达水平相对低下;在SCLC中,Bcl-2过表达,Survivin表达相对不高。Caspase-3在SCLC和NSCLC中的表达差异无显著性。由于组织学差异,SCLC和NSCLC的细胞凋亡过程可能存在不同的凋亡调节通路和凋亡调节因子。

Background and purpose： Abnormal regulation of cell apoptosis is one of causes for oncogenesis. There are a lot of genes involved in the regulation of apoptosis. In this study, the expression of several apoptosis related genes in small cell lung cancer（SCLC） and non-small cell lung cancer（NSCLC） were compared and explored as regards its relationship with different pathology. Descriptive analysis about differences of expression on three proteins of apoptosis genes in different cell types among tumor tissue in same site was made. Methods： The expression of survivin, Bcl-2, Caspase-3 of 41 cases with primary SCLC and 30 with primary NSCLC were detected by immunohistochemical method. The difference about expression of Survivin, Bel-2 and Caspase-3 between SCLC and NSCLC were compared. Results： The expression of Survivin in the SCLC was significantly lower than the NSCLC（P〈0.01）. The expression of Bcl-2 at the SCLC was significantly higher than that in the NSCLC（P〉0.05）. The expression of Caspase-3 was not significantly different between SCLC and NSCLC（P〉0.05）. Conclusion： There is bigger difference process of tumor apoptosis between different cell types in the same topography site. Survivin may play adjuvant roles and Bcl-2 may play main roles in the inhibition of cell apoptosis in SCLC while the case is just reversed in NSCLC, it suggests that there were different apoptosis inducing factor and different apoptosis pathway due to different cell type in NSCLC and SCLC.