直肠癌旁移行黏膜的分布规律及survivin基因表达的意义  

Distributing regularity of transitional mucosa adjacent to rectal carcinoma and the significance of expression of survivin gene

作　　者：苏琪[1] 吴硕东[1] 殷红专[1] 韩霞[1] 陈春生[1] 冯勇[1] 刘恩卿[1] 

机构地区：[1]中国医科大学第二临床学院普外四科,辽宁沈阳110004

出　　处：《中国普通外科杂志》2004年第9期647-649,共3页China Journal of General Surgery

基　　金：辽宁省自然科学基金资助项目 (972 2 55)。

摘　　要：目的　探讨survivin基因在直肠癌旁移行黏膜中的表达及意义。方法　应用黏液组化方法检测了解各种组织类型直肠癌旁移行黏膜的分布规律 ,应用免疫组化方法检测凋亡抑制基因sur vivin在直肠癌及癌前状态的表达情况。结果　黏液癌的癌旁移行黏膜范围平均为 7.83cm ,明显大于乳头状癌及管状腺癌 (P <0 .0 1) ;癌旁移行黏膜DukesC期平均 5 .61cm ,明显大于DukesA ,B期 (P<0 .0 5 ) ;正常黏膜 (NM )、移行黏膜 (TM )、非典型增生黏膜及癌组织中均有survivin基因产物表达 ,由正常直肠黏膜到癌组织表达率逐渐增加 ,4组间差别均有显著意义 (P <0 .0 5 )。结论　在非典型增生及癌组织存在survivin基因表达上调 ,提示survivin基因对直肠癌的发生发展起重要作用 ,有望成为直肠癌基因治疗的新靶点。在黏液癌及DukesC期直肠癌旁移行黏膜范围明显增宽 ,提示对低位黏液癌及DukesC期直肠癌保肛手术应持慎重态度。Objective To study the clinical significance of expression of survivin gene in transitional mucosa(TM) adjacent to rectal carcinoma.Methods Mucinhistochemical methods were used to observe the distribution of TM adjacent to rectal carcinoma, and using immunohistochemical methods to observe the expression of survivin gene product in TM,normal mucosa,atypical dysplasia and cancer tissue.Results The positive expression level of survivin gene product was lowest in normal rectal mucosa,and gradually increase in TM,dysplasia and carcinoma tissue(all P<0.05).The average range of TM in mucous cancer was signficantly longer than that in papillar and tubular cancer(P<0.01);and in Ducks C staging was signficantly longer than that in Ducks A,B staging cancer(P<0.05).Conclusions (1)The up- regulation expression of survivin gene in TM,atypical dysplasia and rectal carcinoma suggeted that survivin may play an important role in the pathway of carcinogenesis and survivin may be identified as a potential gene therapeutic target in carcinoma.(2)The range of TM was closely related to the pathological type and advanced stage of rectal carcinoma.The results indicated that the indications for sphincter preserving operations should be strictly limited in cases of low rectal mucous carcinoma or Dukes C rectal carcinoma.

关 键 词：直肠肿瘤 病理学 粘膜 病理学 凋亡抑制基因 

分 类 号：R735.37[医药卫生—肿瘤] R392.31[医药卫生—临床医学]