Survivin和Caspase-3在肝细胞癌组织中的表达及临床意义

Expression of survivin and Caspase-3 in human hepatocellular carcinoma

目的研究肝细胞癌(HCC)组织及癌旁组织中Survivin、Caspase-3的表达及其与细胞增殖和凋亡的关系。方法收集我院2006年1月～2007年12月肝细胞癌组织及相应癌旁组织标本70例,免疫组化SP法检测其PCNA、Survivin、Caspase-3的表达,并以PCNA阳性强度计算增殖指数(PCNA-PI),原位末端转移酶标记(TUNEL)法检测凋亡指数(AI)。结果Survivin在肝细胞肝癌中表达阳性率高于癌旁组织(P<0.001)。其阳性表达与肿瘤大小、肿瘤细胞分化程度、门静脉癌栓有关。癌组织中Survivin表达阳性者的增殖指数PCNA-PI高于阴性者(P<0.05),凋亡指数低于阴性者(P<0.05)。Caspase-3在肝细胞癌中表达阳性率低于癌旁组织(P=0.05);其阳性表达与肿瘤细胞分化程度和HBsAg有关。癌组织中Caspase-3表达阳性者的增殖指数PCNA-PI低于阴性者(P<0.05),凋亡指数高于阴性者(P=0.05)。在肝癌组织中Survivin与Caspase-3的表达呈负相关(P=0.044)。Survivin阳性肝癌患者生存率低于阴性者(P<0.05)。Caspase-3阴性肝癌患者生存率低于阳性者(P<0.05)。结论Survivin、Caspase-3参与了肝细胞癌的发生发展,Survivin可能通过抑制Caspase-3的活性从而发挥其抑制肝细胞癌细胞凋亡作用,影响预后。

Objective To investigate the expression of Survivin and Caspase-3 in the hepatocellular carcinoma （HCC） and the relationship between Proliferation and Apoptosis.Methods 70 cases from January 2006 to December 2007 which were verified HCC specimens and their neighboring noncancerous tissues were obtained.Immunohistochemistry was used to detect expressions of PCNA Survivin and Caspase-3.PCNA positive level was used to account PCNA-PI （Proliferation index）.TUNEL was employed to examine the apoptosis index of HCC tissues.Results The expression of Survivin in HCC was associated with tumor size,histologic differentiation and Portal Vein tumor embolus.In HCC tissues,the proliferation index of PCNA-PI in Survivin expression positive group was higher than negative group,and the apoptosis index was lower （P0.05）.The expression of Caspase-3 in HCC was associated with histologic differentiation and HBsAg.In HCC tissues,the proliferation index of PCNA-PI in Caspase-3 expression positive group was lower than negative group （P0.05）,and the apoptosis index was higher（P= 0.05）.There was negative correlation between Survivin expression and Caspase-3 expression in HCC （P=0.044）.The Survival rate of the Survivin negative patients was higher than the positive ones （P0.05）.The Survival rate of the Caspase-3 positive patients was higher than the negative （P0.05）.Conclusion Survivin and Caspase-3 participate in the development of HCC.Survivin may produce a marked effect of restraining HCC cell apoptosis through restraining the activity of Caspase-3.