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目的:研究第2个线粒体衍生的半胱氨酸蛋白酶激动剂(Smac)和凋亡抑制基因survivin在鼻腔鼻窦内翻性乳头状瘤(NIP)的发生、发展和恶变过程中的表达情况。方法:选取因鼻中隔偏曲对侧下鼻甲代偿肥大而行下鼻甲部分切除术的下鼻甲黏膜标本(对照组)10例、经病理证实为NIP的患者(NIP组)45例,其中的NIP组根据不同的病理分级分为3组:无不典型增生组25例,不典型增生组11例和恶变组9例,通过免疫组织化学SP法进行Smac及survivin的检测。结果:Smac在NIP组中的阳性表达强度弱于在对照组中的表达,阳性表达强度随NIP病理分化程度的降低而降低,在无不典型增生组及恶变组间的表达差异具有统计学意义。survivin在对照组中为阴性表达,在NIP组中的表达强度增强,NIP组织的分化程度越低,阳性表达强度越高,在无不典型增生组及恶变组间的表达差异有统计学意义。Smac与survivin的表达呈负相关(rs=-0.403,P<0.01)。结论:Smac和survivin与NIP的发病及恶变相关。
Objective: To investigate the expression of the second mitochondria-derived cysteine protease (Smac) and survivin in the pathogenesis, progression and malignant transformation of nasal inverted papilloma (NIP). Methods: Ten cases of inferior turbinate mucosa (control group) underwent partial nasotomy under compensatory hypertrophy of nasolabial septum and 45 cases of pathologically confirmed NIP (NIP group), including NIP According to different pathological grades, the patients were divided into three groups: 25 cases in non-typical hyperplasia group, 11 cases in atypical hyperplasia group and 9 cases in malignant group. Smac and survivin were detected by immunohistochemical SP method. Results: The positive expression of Smac in NIP group was weaker than that in control group. The positive expression intensity of Smac was decreased with the decrease of pathological differentiation degree of NIP. The expression of Smac in non-dysplasia group and malignant group was statistically significant. The expression of survivin in the control group was negative, the intensity of expression in the NIP group was enhanced, the differentiation degree of the NIP tissue was lower, the positive expression intensity of survivin was higher, and the difference was statistically significant between the non-dysplasia group and malignant group. The expression of Smac and survivin was negatively correlated (rs = -0.403, P <0.01). Conclusion: Smac and survivin are associated with the pathogenesis and malignant transformation of NIP.