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目的探讨凋亡抑制基因生存素蛋白(survivin)在贲门癌组织中的表达及其与各临床病理因素的关系。方法采用二步法免疫组化技术(Envision),检测66例贲门癌组织中survivin的表达情况,分析survivin与各临床病理因素间的关系。结果肿瘤组织及癌旁组织survivin阳性表达率分别为62.1%、24.2%,正常胃黏膜无survivin表达,三者之间阳性率差异有统计学意义(P<0.05)。survivin蛋白在低分化贲门癌中的表达为73.8%,高、中分化癌的表达为41.7%,在伴有淋巴结转移者表达为73.3%,无淋巴结转移者表达为38.1%,伴有浆膜层浸润者表达为74.4%,无浆膜层浸润者表达为44.4%,以上差异均有统计学意义(P<0.05)。TNM分期Ⅲ期的贲门癌survivin表达阳性率(95%)显著高于Ⅰ,Ⅱ期患者(47.8%),差异有统计学意义(P<0.05)。survivin基因表达与贲门癌的年龄、性别及肿瘤大小无显著相关性。结论凋亡抑制基因survivin与贲门癌发生、发展有一定联系,检测其表达对于判断贲门癌的恶性程度及病情进展有一定的价值。
Objective To investigate the expression of survivin in gastric cardia carcinoma and its relationship with clinicopathological factors. Methods Envision was used to detect the expression of survivin in 66 cases of gastric cardia carcinoma. The relationship between survivin and clinicopathological factors was analyzed. Results The positive rates of survivin in tumor tissues and adjacent tissues were 62.1% and 24.2%, respectively. There was no expression of survivin in normal gastric mucosa. There was significant difference between them (P <0.05). The expression of survivin protein was 73.8% in poorly differentiated cardia carcinoma, 41.7% in high and moderately differentiated carcinoma, 73.3% in lymph node metastasis and 38.1% in non-lymph node metastasis with serosa The infiltrate was 74.4%, while the infiltration of serosa was 44.4%, all of the above differences were statistically significant (P <0.05). The positive expression rate of survivin in gastric cardia carcinoma (95%) in stage Ⅲ TNM was significantly higher than that in stage Ⅰ and Ⅱ (47.8%), the difference was statistically significant (P <0.05). There was no significant correlation between the expression of survivin gene and the age, sex and tumor size of cardiac cancer. Conclusions Survivin, an inhibitor of apoptosis, is associated with the occurrence and development of gastric cardia carcinoma. To detect the expression of survivin is of value in judging the malignancy and progression of cardia carcinoma.