大肠腺癌组织Survivin蛋白的表达意义  

Expression of survivin protein in colorectal adenocarcinoma

作　　者：肖军[1] 邓长生[1] 朱尤庆[1] 

机构地区：[1]武汉大学中南医院消化内科,湖北省武汉市430071

出　　处：《世界华人消化杂志》2003年第5期540-543,共4页World Chinese Journal of Digestology

摘　　要：目的:检测凋亡抑制蛋白Survivin在大肠腺瘤、腺癌组织中的表达,观察其与细胞增生、凋亡的关系,探讨Survivin基因表达在大肠癌发生、发展过程中的作用.方法:应用DNA缺口未端标记技术和免疫组织化学S-P法,原位观察20例正常大肠黏膜组织、35例大肠腺瘤和60例大肠腺癌组织中的凋亡细胞和Survivin、Ki-67蛋白阳性表达.结果:Survivin蛋白在正常大肠黏膜组织中不表达,在大肠腺癌和腺瘤中阳性表达率分别为60.0%和17.1%,二者比较差异有显著性(P<0.01).Survivin蛋白表达与大肠腺癌分化程度呈负相关,与Dukes’分期和淋巴结转移无明显相关.大肠腺癌Ki-67标记指数(labelingindex,LI)为39.1±10.4%,较腺瘤22.3±6.2%显著增高(P<0.01),大肠腺癌Survivin阳性组Ki-67LI25.1±7.6%与Survivin阴性组19.7±5.8%比较差异有显著性(P<0.01).大肠腺瘤和腺癌细胞凋亡指数(AI)显著高于正常大肠黏膜(P<0.01),高分化癌凋亡指数显著高于低分化癌(P<0.05),大肠腺癌Survivin阳性组凋亡指数0.85±0.52%与Survivin阴性组1.25±0.58%比较差异有显著性(P<0.01).结论:Survivin基因在大肠腺癌组织中表达上凋,通过促进肿瘤细胞增生和抑制凋亡参与大肠癌的发生、发展过程.检测大肠组织Survivin蛋白表达,对预测癌变及判断预后有重要意义.Survivin基因为肿瘤的基因治疗提供一理想靶点.AIM:To investigate the expression of survivin and its relationship with proliferation and apoptosis in colorectal adenoma and adenocarcinoma. METHODS:Using terminal deoxynucleotidyl transferase- mediated dUTP nick end labeling (TUNEL) and immuno histochemistry S-P method, the authors examined the expression of survivin, Ki-67 and apoptotic cell in situ in 60 cases of colorectal adenocarcinoma, 35 adenoma and 20 normal colonic mucosa. RESULTS:Survivin expression was observed in 36 of 60 (60.0 %) cases of colorectal adenocarcinoma and in 6 of 35 (17.1 %) cases of adenoma. In contrast, normal colonic mucosa did not express survivin. Overexpression of survivin was related to the differentiation grade of colorectal adenocarcinoma, however there was no correlation with Dukes’s stage of lymph node metastasis. Ki-67 labeling index (LI) was higher in colorectal adenocarcinoma than that in adenoma (39.1± 10.4 % versus 22.3 ± 6.2 %, P <0.01). The apoptosis in- dex (AI) of colorectal adenocarcinoma and adenoma was significantly higher than that of normal tissues (P <0.01). More apoptotic cells were noticed in well and moderate differentiated adenocarcinoma than those in poorly differentiated adenocarcinoma (P <0.05). Survivin positive adenoma and adenocarcinoma had significantly lower values for AI than survivin negative tumors (P <0.01), and the Ki-67 LI in survivin positive adenoma and adenocarcinoma were higher than that in survivin negative tumors (P <0.01). CONCLUSION:Up-regulation of survivin expression in adenocarcinoma suggests that survivin may play an important role in human colorectal tumorigenesis through the inhibition of apoptosis and acceleration of proliferative activity. Survivinmay be a new prognostic implication in colorectal adenocarcinoma and serve as a widely applicable target for anticancer gene therapy.

关 键 词：大肠腺癌 SURVIVIN蛋白 临床意义 凋亡抑制蛋白 细胞增生 细胞凋亡 免疫组织化学S-P法 基因治疗 

分 类 号：R735.34[医药卫生—肿瘤]