原发与继发性胶质母细胞瘤中survivin表达及其意义  

Expression of survivin in primary and secondary glioblastoma and its significance

作　　者：耿军[1] 谢丹[2] 黎志勋[2] 黄纲[1] 陈晓雷[1] 吴新建[1] 刘泳冬[2] 耿瑞明[3] 文剑明[2] 

机构地区：[1]中山大学附属第一医院外科,广州510080 [2]中山大学基础医学院病理学教研室,广州510089 [3]中山大学附属第一医院黄埔分院外科,广州510000

出　　处：《临床与实验病理学杂志》2005年第4期403-406,共4页Chinese Journal of Clinical and Experimental Pathology

基　　金：广东省社会发展科技攻关项目基金资助课题(99M04908G)

摘　　要：目的探讨survivin蛋白在原发与继发性胶质母细胞瘤(glioblastoma,GBM)中的表达及其临床病理学意义。方法分别应用免疫组化和TUNEL方法,检测56例GBM(30例原发和26例继发)中survivin的表达和细胞凋亡情况,比较survivin在原发与继发性GBM中的表达差异;分析survivin表达与GBM临床病理学参数之间的相关性。结果56例GBM中,原发GBM中83%(25/30例)呈survivin阳性,继发性GBM中仅46%(12/26例)呈阳性,二者差异有显著性(P<0.01)。在15例配对的继发性GBM与其初发的低级别胶质瘤中,survivin的表达基本一致,7例survivin阳性表达的继发性GBM,其对应的7例低级别胶质瘤中,有6例同时出现survivin阳性;而且多数(4/5例)由间变性胶质瘤(III级)发展而成的继发性GBM出现了survivin的阳性表达,其阳性率明显高于由Ⅱ级胶质瘤演变而成的继发性GBM(3/10例)。另外,大多数(80%)瘤体直径>5cm的GBM呈survivin阳性,并多表现为低的细胞凋亡指数。结论Survivin的阳性表达可能通过其抗凋亡效应,在绝大多数原发性GBM的发生、发展中起了十分重要的作用,但可能只涉及部分继发性GBM的恶性演变;在继发性GBM发生、发展中,survivin阳性表达可能与其初发胶质瘤的病理级别有关。Purpose To investigate the expression of survivin in primary and secondary glioblastoma （ GBM ） and its clinicopathological significance. Methods lmmunohistochemistry and TUNEL method were used to examine the expression of survivin and the status of apoptosis in 56 cases of primary and secondary GBMs, respectively, to compare the differential expression of this protein between primary and secondary GBM and analyze the association of survivin expression with patient＇s clinicopathological features. Results In 56 GBMs, there was a significant differential expression of survivin between primary and secondary GBMs （ P〈0.01 ）, where most （83%, 25/30） primary GBMs were observed positive expression of survivin, while only 46% （12/26） of secondary GBMs showed survivin positivity. Of the 15 paired secondary GBMs and their precursor lesions of low-graded glioma, the expression pattern of survivin was similar, 7 secondary GBMs showed positive expression of survivin, in which 6 of the 7 paired lesions were observed survivin positivity. In addition, the majority （4/5） of secondary GBMs developed from a precursor lesion of anaplastic glioma （grade Ⅲ ） were observed positive expression of survivin, which was obviously higher than that （3/10） in secondary GBMs from grade Ⅱ glioma. Furthermore, in these GBM series, the majority （ 80% ） of larger GBMs （ tumor〉5cm in diameter） showed survivin positivity and meanwhile, the majority （78%） of GBMs with positive expression of survivin were observed a lower apoptotic index （AI）. Conclusions The positive expression of survivin may play an important role in the development of most primary GBMs via its anti-apoptosis mechanism, but it may only involve in the progression of a small portion of secondary GBMs. In the tumorigenesis of secondary GBMs, the positive expression of survivin might be associated with the pathological grade of the precursor lesion of secondary GBM.

关 键 词：胶质母细胞瘤 SURVIVIN 免疫组织化学 细胞凋亡 

分 类 号：R739.41[医药卫生—肿瘤]