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目的探讨大肠黏膜癌变过程中survivin、p16表达及微血管密度检测的临床意义。方法免疫组化SABC法检测正常大肠黏膜(15例),炎性息肉(15例),腺瘤性息肉(23例)和原发性大肠癌(48例)组织中survivin、p16蛋白表达和微血管密度(MVD)。结果(1)survivin阳性表达率在正常大肠黏膜、炎性及腺瘤性息肉和大肠癌组中呈递增趋势,大肠癌和腺瘤性息肉组明显高于正常黏膜组。p16阳性表达率呈递减趋势,大肠癌组低于正常黏膜组。MVD呈递增趋势,大肠癌与腺瘤性息肉组较正常黏膜组明显增高。(2)survivin表达与年龄、性别、肿瘤部位无关,与分化程度和Duke分期有关;MVD仅与Dukes分期有关;p16表达与上述临床病理特征无关。(3)survivin和p16表达、p16表达与MVD均呈负相关;survivin表达与MVD呈正相关;survivin-/p16+组MVD明显低于survivin+/p16-和survivin+/p16+组,与survivin-/p16-相组比有降低趋势。结论survivin高表达、p16表达缺失和MVD增高在大肠黏膜癌变过程中起重要作用。三者联合检查对于大肠癌早期诊断具有一定的参考价值。survivin和p16与肿瘤血管生成有关。
Objective To investigate the clinical significance of survivin, p16 expression and microvessel density in the process of carcinogenesis of large intestine mucosa. Methods The expressions of survivin and p16 protein in normal colorectal mucosa (15 cases), inflammatory polyps (15 cases), adenomatous polyps (23 cases) and primary colorectal carcinoma (48 cases) were detected by immunohistochemical SABC method. Density (MVD). Results (1) The positive rate of survivin in normal colorectal mucosa, inflammatory and adenomatous polyps and colorectal cancer groups showed an increasing trend, and colorectal cancer and adenomatous polyps group was significantly higher than the normal mucosa group. p16 positive expression rate showed a decreasing trend, colorectal cancer group than normal mucosa group. MVD showed an increasing trend, colorectal cancer and adenomatous polyps group than the normal mucosa was significantly higher. (2) Survivin expression was not related to age, sex and tumor location, but was related to the degree of differentiation and Duke staging; MVD was only related to Dukes stage; p16 expression was not associated with the above clinicopathological features. (3) The expression of survivin and p16, the expression of p16 and MVD were negatively correlated, the expression of survivin was positively correlated with MVD. The MVD of survivin- / p16 + group was significantly lower than that of survivin + / p16- and survivin + / p16 + Group than there is a downward trend. Conclusion The high expression of survivin, the loss of p16 expression and the increase of MVD play an important role in carcinogenesis of large intestinal mucosa. The three joint examination for the early diagnosis of colorectal cancer has a certain reference value. Survivin and p16 are associated with tumor angiogenesis.