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目的探讨survivin,caspase-3及Cox-2蛋白表达与胆囊癌生物学行为及临床病理指标的关系。方法检测4 9例胆囊癌、9例胆囊腺瘤、1 0例慢性胆囊炎组织中survivin,caspase-3及Cox-2的表达。结果(1)survivin,caspase-3及Cox-2在胆囊癌组织中阳性表达率分别为6 5.3%(3 2/4 9),4 4.9%(2 2/4 9)和7 5.5%(3 7/4 9),显著高于胆囊良性病变组织(分别为P<0.0 0 1,<0.0 0 1及=0.0 0 1)。(2)survivin表达与肿瘤浸润程度、分化程度、淋巴结转移及Nevin分期均无显著关系(均P>0.0 5);caspase-3表达与分化程度有关而与肿瘤浸润程度、淋巴结转移、Nevin分期无关;Cox-2阳性率在淋巴结转移组与非转移组、不同浸润深度以及Nevin分期间差异均有显著性,而与组织学分级无关。三者均与患者的年龄、性别无关。(3)survivin与caspase-3表达呈负相关(r=-0.3 7 3,P=0.0 0 8),survivin与Cox-2表达呈正相关(r=0.4 0 4,P=0.0 0 4),caspase-3与Cox-2表达无明显相关性(r=-0.1 5 6,P=0.2 8 4)。结论胆囊癌组织caspase-3表达较低,而survivin及Cox-2表达较高;survivin和Cox-2的过表达以及caspase-3的失表达在胆囊癌的发生、发展中起重要作用。survivin和Cox-2蛋白可望作为靶点用于胆囊癌靶向治疗。
Objective To investigate the relationship between the expression of survivin, caspase-3 and Cox-2 protein and the biological behavior and clinicopathological parameters of gallbladder carcinoma. Methods The expressions of survivin, caspase-3 and Cox-2 in 49 cases of gallbladder carcinoma, 9 cases of gallbladder adenoma and 10 cases of chronic cholecystitis were detected. Results (1) The positive expression rates of survivin, caspase-3 and Cox-2 in gallbladder carcinoma were 6 5.3% (3 2/4 9), 4 4.9% (2 2/4 9) and 7 5.5% (3). 7/4 9), significantly higher than benign lesions of gallbladder (P <0.0 0 1, <0.0 0 1 and = 0.0 01, respectively). (2) There was no significant relationship between the expression of survivin and the degree of tumor invasion, differentiation, lymph node metastasis and Nevin stage (all P>0.0 5). The expression of caspase-3 was related to the degree of differentiation but not to the degree of tumor infiltration, lymph node metastasis and Nevin stage. The positive rate of Cox-2 was significantly different between lymph node metastasis group and non-metastatic group, different depth of invasion, and Nevin period, but had no relationship with histological grade. All three were not related to the patient’s age or gender. (3) The expression of survivin was negatively correlated with the expression of caspase-3 (r=-0.3 7 3, P=0.0 08). The expression of survivin was positively correlated with the expression of Cox-2 (r=0.4 0 4, P=0.0 04). There was no significant correlation between -3 and Cox-2 expression (r=-0.1 5 6, P=0.2 84). Conclusions The expression of caspase-3 in gallbladder carcinoma is low, while the expression of survivin and Cox-2 is high. Overexpression of survivin and Cox-2 and loss of caspase-3 play an important role in the occurrence and development of gallbladder carcinoma. The survivin and Cox-2 proteins are expected to be targeted for the targeted therapy of gallbladder cancer.