腹腔镜手术对早期宫颈癌Survivin、Bax表达的影响

The impact of laparoscopic surgery on the expression of survivin and bax in early cervical cancer

目的探讨腹腔镜手术治疗早期宫颈癌对癌细胞Survivin和Bax表达的影响。方法选择宫颈癌患者各20例分别行开腹及腹腔镜下广泛子宫全切加盆腔淋巴结清扫术,并与开腹及腹腔镜下全子宫切除术的宫颈上皮内瘤变Ⅲ(CINⅢ)级患者各30例相对比,采用免疫组化法测定两组患者腹腔镜及开腹手术术前、后癌组织Survivin和Bax的表达并比较其变化。结果宫颈癌术后癌细胞Survivin表达阳性率开腹、腹腔镜组分别为45.0%及25.0%,较术前降低,但两组比较差异无显著性(P>0.05),Bax阳性表达率开腹、腹腔镜组术后分别为30.0%、70.0%,较术前上升,两组比较差异也无显著性(P>0.05)。CINⅢ患者中术后Survivin和Bax阳性表达率腹腔镜组与开腹组比较变化不明显(P>0.05)。结论与开腹手术相比,腹腔镜手术治疗早期子宫颈癌,可能不会促进或抑制肿瘤凋亡基因Survivin和Bax的表达而增强肿瘤细胞的增殖力。

[Objective ] To investigate the influence of laparoscopic surgery on survivin and bax expression in early cervical cancer. [ Methods ] Each pair of 20 patients with early cervical carcinoma underwent radical hysterectomy and pelvic lymphadenectomy through laparoscopic and abdominal methods separately. Each pair of 30 patients with cervical intraepithelial neoplasm HI （C1N llI） underwent laparoscopic and abdominal total hysterectomy sepa- rately. The expression of survivin and bax in tumor tissue samples was determined by immunohistochemistry before and after laparoscopy and open surgery. The changes in survivin and bax expression levels from preoperative to post- operative sampling of laparoscopic versus open surgery were compared. [ Results ] The positive rate of survivin was 45.0% in postoperative samples of open surgery, and 25.0% in postoperative samples of laparoscopic surgery. The survivin expression decreased postoperatively, though there were no significant differences between the two groups in early cervical cancer （P 〉0.05）. Increased bax expression was found in 70.0% of postoperative laparoscopic surgery group, and 40.0% of postoperative open surgery group, though there were no significant differences between the two groups in early cervical cancer （P 〉0.05）. Preoperative and postoperative data revealed no significant changes in survivin and bax expression of laparoscopic surgery group as compared to open surgery group in CIN HI （P 〉0.05）. [ Conclusion] Our data suggest that laparoscopic surgery may not have influence on tumor apoptosis gene expression to promote tumor proliferation potentiality as compared to abdominal surgery.