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背景与目的:survivin基因是凋亡抑制蛋白(IAP)家族的新成员,其组织分布具有明显的细胞选择性,即仅表达于胚胎及胎儿组织及大多数癌瘤组织中,而不表达于终末分化的成人组织。本研究探讨survivin在宫颈鳞癌组织中的表达及其与HPV-16感染及p53表达的相关性。方法:应用免疫组织化学链霉素抗生物素蛋白过氧化酶连接法(S-P法)检测survivin、HPV-16、p53基因在21例正常宫颈组织、23例CIN及72例宫颈鳞癌组织中的表达。结果:survivin基因在正常宫颈组织中不表达,在23例CIN中4例表达阳性,占17.39%,与正常宫颈组比较,差异有显著性(P<0.01,χ2=9.210),在72例宫颈鳞癌组织中52例表达阳性,占72.22%,其中病理分级为G1级的宫颈鳞癌中survivin基因表达阳性率为61.3%,(17/35),G2/G3级为89.19%(33/37),两者比较,差异有显著性(P<0.01,χ2=9.5211)。临床分期Ⅰ期的宫颈鳞癌的survivin基因表达阳性率为31例中有16例,占51.61%,临床分期Ⅱ期的宫颈鳞癌的survivin基因表达阳性率为28例中有24例,占85.71%,Ⅲ期者为92.30%(12/13),两两比较,Ⅰ期与Ⅱ期,Ⅰ期与Ⅲ期差异均有显著性(P<0.01),Ⅱ期与Ⅲ期差异无显著性(P>0.05)。survivin基因表达阳性率与宫颈鳞癌的病理分级和临床分期呈正相关。宫颈鳞癌组织中P53蛋白表达阳性、阴性者中survivin基因表达阳性率分别为84.78%(39/46),50.00%(13/26),两者比较,差异有显著性(P<0.05)。HPV-16表达阳性、阴性者中survivin基因表达率分别为81.4%(35/43),58.6%(17/29),两者比较,差异有显著性(P<0.05)。survivin基因表达阳性率与宫颈鳞癌组织中p53及HPV-16表达有相关性。结论:①survivin基因的表达与宫颈鳞癌的临床分期、病理分级及患者预后密切相关,其高表达提示宫颈鳞癌预后不良。②survivin基因的表达与宫颈鳞癌组织中p53突变及HPV-16感染呈正相关。
BACKGROUND & OBJECTIVE: The survivin gene is a new member of the apoptosis-inhibitory protein (IAP) family. The tissue distribution of the survivin gene is obviously cell-selective, which is only expressed in embryonic and fetal tissues and most cancerous tissues, but not in the end End differentiated adult tissue. This study was to investigate the expression of survivin in cervical squamous cell carcinoma and its relationship with HPV-16 infection and p53 expression. Methods: The expressions of survivin, HPV-16 and p53 were detected by immunohistochemical streptavidin-avidin-peroxidase (SP method) in 21 cases of normal cervical tissue, 23 cases of CIN and 72 cases of cervical squamous cell carcinoma expression. Results: The survivin gene was not expressed in normal cervical tissue. The positive expression rate of survivin gene in 4 of 23 CIN specimens was 17.39% (P <0.01, χ2 = 9.210) The positive expression rate of survivin gene in cervical squamous cell carcinoma was 61.3% (17/35) and G2 / G3 was 89.19% (33/37) in 52 cases of squamous cell carcinoma, accounting for 72.22% ), The difference between the two was significant (P <0.01, χ2 = 9.5211). The positive rate of survivin gene expression in clinical stage Ⅰ cervical cancer was 16 of 31 (51.61%). The positive rate of survivin gene expression in clinical stage Ⅱ cervical cancer was 24 of 28 (85.71%) %, And those in stage Ⅲ were 92.30% (12/13). There was a significant difference between stage Ⅰ and stage Ⅱ, stage Ⅰ and stage Ⅲ (P <0.01), stage Ⅱ and stage Ⅲ P> 0.05). The positive rate of survivin gene expression was positively correlated with the pathological grade and clinical stage of cervical squamous cell carcinoma. The positive rates of survivin gene expression in cervical squamous cell carcinoma tissues were 84.78% (39/46) and 50.00% (13/26), respectively. There was significant difference between the two groups (P <0.05). The positive rate of survivin gene in HPV-16 positive and negative tissues was 81.4% (35/43) and 58.6% (17/29), respectively. There was significant difference between the two groups (P <0.05). The positive rate of survivin gene was correlated with the expression of p53 and HPV-16 in cervical squamous cell carcinoma. Conclusion: ① The expression of survivin gene is closely related to the clinical stage, pathological grade and prognosis of cervical squamous cell carcinoma. The high expression of survivin gene suggests that the prognosis of cervical squamous cell carcinoma is poor. The expression of survivin gene was positively correlated with p53 mutation and HPV-16 infection in cervical squamous cell carcinoma.