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背景与目的:肾上腺肿瘤的组织形态学特征比较特殊,仅根据组织病理切片检查难以判断肿瘤的良、恶性程度,给治疗带来很大的困难。本研究旨在探讨Survivin蛋白和PTEN蛋白表达在肾上腺肿瘤的临床诊断及预后评估中的价值。方法:采用免疫组织化学LSAB方法分别对116例肾上腺肿瘤组织标本进行Survivin蛋白和PTEN蛋白表达的检测,分为“-”、“+”、“++”、“+++”、“++++”5个等级,采用SPSS13.0软件进行分析。结果:按“-”、“+”、“++”、“+++”、“++++”划分,Survivin蛋白的表达分别为29例(25.0%)、36例(31.0%)、30例(25.9%)、14例(12.1%)、7例(6.0%);PTEN蛋白的表达分别为8例(6.9%)、17例(14.7%)、30例(25.9%)、33例(28.4%)、28例(24.1%)。Survivin蛋白和PTEN蛋白的表达呈明显负相关(r=-0.486,P<0.05)。Survivin蛋白和PTEN蛋白的表达与肾上腺肿瘤患者年龄、性别、肿瘤部位等无明显相关性(P>0.05)。肾上腺皮质腺瘤中Survivin蛋白的表达明显低于肾上腺皮质腺癌(P<0.05);良性嗜铬细胞瘤Survivin蛋白的表达明显低于恶性嗜铬细胞瘤(P<0.05)。肾上腺皮质腺瘤中PTEN蛋白的表达明显高于肾上腺皮质腺癌(P<0.05),良性嗜铬细胞瘤PTEN蛋白的表达明显高于恶性嗜铬细胞瘤(P<0.05)。Survivin蛋白的表达与肾上腺皮质腺癌和恶性嗜铬细胞瘤患者的预后均相关(P<0.05),Survivin蛋白表达越强,患者预后越差。PTEN蛋白的表达与肾上腺皮质腺癌、恶性嗜铬细胞瘤患者的预后均相关(P<0.05),PTEN蛋白表达越低,患者预后越差。结论:Survivin蛋白和PTEN蛋白在肾上腺肿瘤组织中的表达与肾上腺肿瘤恶性程度及预后相关。
BACKGROUND & OBJECTIVE: Adrenal tumors have special histomorphological features. It is difficult to determine the degree of malignancy and malignancy of the tumor only based on histopathological examination, which poses great difficulties for the treatment. This study aimed to investigate the value of Survivin protein and PTEN protein expression in the clinical diagnosis and prognosis of adrenal tumors. Methods: The expressions of Survivin protein and PTEN protein in 116 cases of adrenal tumor tissues were detected by immunohistochemistry LSAB method and divided into “”, “ ++ ”, “ ++++ ”five levels, using SPSS13.0 software for analysis. Results: The expression of Survivin protein was 29 cases (25.0%) according to “- ”, “+ ”, “++ ”, “+++ ” and "++++ 36 cases were 31.0%, 30 cases were 25.9%, 14 cases were 12.1% and 7 cases were 6.0%. The expression of PTEN protein was 8 cases (6.9%), 17 cases (14.7%), , 30 cases (25.9%), 33 cases (28.4%) and 28 cases (24.1%). Survivin protein and PTEN protein expression was negatively correlated (r = -0.486, P <0.05). The expression of Survivin protein and PTEN protein had no significant correlation with age, sex, tumor location and so on (P> 0.05). The expression of Survivin protein in adrenocortical adenoma was significantly lower than that in adrenocortical adenocarcinoma (P <0.05). The expression of Survivin protein in benign pheochromocytoma was significantly lower than that in malignant pheochromocytoma (P <0.05). The expression of PTEN protein in adrenocortical adenoma was significantly higher than that in adrenocortical adenocarcinoma (P <0.05). The expression of PTEN protein in benign pheochromocytoma was significantly higher than that in malignant pheochromocytoma (P <0.05). The expression of Survivin protein was correlated with the prognosis of patients with adrenocortical adenocarcinoma and malignant pheochromocytoma (P <0.05). The higher the Survivin protein expression, the worse the prognosis of patients. The expression of PTEN protein was correlated with the prognosis of adrenocortical adenocarcinoma and malignant pheochromocytoma (P <0.05). The lower the expression of PTEN protein, the poorer the prognosis of patients. Conclusion: The expression of Survivin protein and PTEN protein in adrenal tumor is related to the malignant degree and prognosis of adrenal tumor.