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目的探讨Caspase-3和Survivin在儿童皮肤血管瘤不同时期的表达和意义。方法收集甘肃省人民医院病理科2000年1月-2005年12月手术切除皮肤血管瘤存档蜡块55例及手术切除正常皮肤标本8例,根据Mulliken标准进行病理诊断并分类,所有标本共分3组,其中增殖期组31例,退化期组24例及正常对照组8例。采用免疫组织化学SP法对2组血管瘤及正常皮肤组织中Caspase-3和Survivin进行染色,以正常血管上皮细胞或肿瘤细胞胞质和(或)胞核出现棕黄色颗粒为阳性,检测各组血管内皮细胞Caspase-3和Survivin的阳性表达情况。结果Caspase-3阳性表达率在增生期和消退期分别为35.5%和79.2%,消退期显著高于增生期(P=0.0459),增生期与正常皮肤组织表达无显著性差异(P=0.0573)。Survivin阳性表达率在增生期和消退期分别为77.4%和45.8%,增生期显著高于消退期(P=0.0085),消退期与正常皮肤组织表达无显著性差异(P=0.0593)。结论Caspase-3在儿童皮肤血管瘤消退期的高表达提示该基因可能在血管瘤消退期促进内皮细胞凋亡方面发挥作用,而Survivin在增殖期内皮细胞的高表达,提示其可能抑制了血管瘤内皮细胞的凋亡过程,Caspase-3和Surivivin参与了血管瘤中细胞凋亡的调节。
Objective To investigate the expression and significance of Caspase-3 and Survivin in different stages of childhood cutaneous hemangiomas. Methods 55 cases of paraffin embedded hemangiomas were collected from January 2000 to December 2005 in Department of Pathology, People’s Hospital of Gansu Province, and 8 cases of normal skin specimens were resected. According to Mulliken criteria, pathological diagnosis and classification were performed. All specimens were divided into 3 groups Group, including 31 cases of proliferative group, 24 cases of degenerative group and 8 cases of normal control group. Caspase-3 and Survivin in 2 groups of hemangiomas and normal skin tissues were stained by immunohistochemical SP method, and the positive cells of brown or yellow appeared in the cytoplasm and / or nucleus of normal vascular epithelial cells or tumor cells, Positive expression of Caspase-3 and Survivin in vascular endothelial cells. Results The positive expression rates of Caspase-3 in the proliferative phase and regressive phase were 35.5% and 79.2%, respectively, which were significantly higher than those in the proliferative phase (P = 0.0459). There was no significant difference between the proliferative phase and the normal skin tissue (P = 0.0573) . The positive expression rate of Survivin was 77.4% and 45.8% respectively in proliferative and remission stages, and significantly higher in proliferative stage than that in regressive stage (P = 0.0085). There was no significant difference between normal skin tissue and remission stage (P = 0.0593). Conclusions The high expression of Caspase-3 in the regression of childhood hemangiomas suggests that this gene may play a role in the promotion of endothelial cell apoptosis in the regression of hemangiomas. However, the overexpression of Survivin in proliferating endothelial cells suggests that it may inhibit hemangiomas The process of endothelial cell apoptosis, Caspase-3 and Survivin are involved in the regulation of apoptosis in hemangiomas.