生存素在胃癌及其癌前病变中的表达和临床意义  

Expression and Clinical Significance of Survivin in Gastric Cancer and its Precancerous Lesions

作　　者：曹勤[1] 陈锡美[2] 

机构地区：[1]上海市普陀区中心医院消化内科,200062 [2]同济大学附属同济医院消化内科

出　　处：《胃肠病学》2004年第6期351-354,共4页Chinese Journal of Gastroenterology

摘　　要：背景:生存素(survivin)是凋亡抑制蛋白家族的成员,在胃癌和癌前病变中可能有一定程度的表达,对胃癌和癌前病变的诊断有相当重要的意义。目的:探讨生存素在不同胃黏膜病变中的表达,以及胃癌组织中生存素的表达与胃癌临床病理参数的关系,以阐明生存素在胃癌发生中的作用和临床意义。方法:分别应用逆转录聚合酶链反应(RT鄄PCR)和免疫组化法检测生存素mRNA和蛋白在慢性非萎缩性胃炎、胃癌前病变和胃癌组织中的表达,分析胃癌组织中生存素的表达与胃癌临床病理参数的关系。结果:慢性非萎缩性胃炎、胃癌前病变和胃癌组织中生存素mRNA的表达率分别为2.5%、25.0%和59.6%,生存素蛋白的表达率分别为0%、15.0%和51.9%,三组间差异有统计学意义(P<0.05)。肿瘤累及浆膜层、有局部淋巴结转移和TNM分期Ⅲ～Ⅳ期胃癌患者癌组织中生存素mRNA和蛋白的表达率分别显著高于肿瘤未累及浆膜层、无淋巴结转移和TNM分期Ⅰ～Ⅱ期者(P<0.05)。结论:生存素在胃癌中有较高的表达率,其表达与胃癌的浸润深度、局部淋巴结转移和TNM分期相关。生存素基因可能参与了正常胃黏膜、癌前病变至胃癌的转化过程,可作为胃癌的独立预后指标。Background: Survivin, a member of inhibitors of apoptosis protein, is expressed to a certain degree in gastric cancer and its precancerous lesions, and may be valuable in the diagnosis of the two diseases. Aims: To investigate the expression of survivin in different gastric mucosal lesions, and the relationship between survivin expression in gastric cancerous tissues and the clinicopathologic parameters of gastric cancer, so as to clarify the mechanism and clinical significance of survivin in the development of gastric cancer. Methods: Reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemical method were used respectively to detect the expression of survivin at mRNA and protein levels in specimens of chronic non-atrophic gastritis, gastric precancerous lesions and gastric cancer. The relationship between survivin expression in gastric cancerous tissues and the clinicopathologic parameters of gastric cancer was analyzed. Results: In the specimens of chronic non-atrophic gastritis, gastric precancerous lesions and gastric cancer, the expression rates of survivin mRNA were 2.5%, 25.0% and 59.6%, and survivin protein were 0%, 15.0% and 51.9%, respectively. Statistical significance could be found among the three groups (P<0.05). The expression rates of survivin mRNA and protein in gastric cancerous tissues were significantly higher in patients with serosal invasion, regional lymph node metastasis and TNM stage Ⅲ～Ⅳ than those without serosal invasion, absence of lymph node metastasis and TNM stage Ⅰ～Ⅱ ones, respect-ively (P<0.05). Conclusions: Survivin is overexpressed in gastric cancer, and correlates with infiltration depth, regional lymph node metastasis and TNM staging of gastric cancer. Survivin gene may play an important role in the transformation from normal gastric mucosa to precancerous lesions and eventually to gastric cancer, and be an independent prognostic indicator for patients with gastric cancer.

关 键 词：生存素 胃癌组织 表达率 癌前病变 肿瘤 TNM分期 临床意义 RNA 蛋白 RT-PCR 

分 类 号：R735.2[医药卫生—肿瘤]