Yao Xue-quan, Liu Fu-kun, Qi Xiao-ping, Wu Bo, Yin Hong-lin, Ma Heng-hui, Shi Qun-li, Zhou Xiao-jun, Li Jie-shou
Institute of General Surgery, Nanjing General Hospital of People's Liberation Army, Medical School of Nanjing University, Nanjing 210002, China.
Zhonghua Wai Ke Za Zhi. 2004 Feb 7;42(3):145-8.
To investigate the expression and significance of survivin, ki-67 and apoptosis index in patients with advanced gastric adenocarcinoma.
Immunohistochemical SP method for survivin expression as well as cell proliferative index (ki-67) and apoptosis index (TUNEL) was conducted on 120 gastric adenocarcinomas.
The survivin was detected in the cytoplasm of carcinoma cells in 59 (49.17%) of the 120 gastric adenocarcinomas, in 32 (64.00%) of the lymph node metastasis, and in 21 (17.50%) of the 120 basal layer in normal gastric mucosa, respectively. The mean proliferative index (ki-67) in primary tumors was 7.55%, which was significantly lower than the mean proliferative index of 8.34% observed in lymph node metastasis. The mean apoptosis index in primary tumors was 1.16%, which was significantly higher than the mean apoptosis index of 0.89% observed in lymph node metastasis. The frequency of survivin expression was significantly higher in lymph node metastasis than in primary gastric adenocarcinoma. Expression of survivin was significantly correlated with histological subtypes, the depth of invasion, or lymph node metastasis (P < 0.05). There was negative correlation between weighted survivin score and apoptosis index (P < 0.05), but no correlation with proliferative index.
The high level expression of survivin might be a referenced indicator in evaluating differentiation of tumor and in predicting lymph nodes metastasis and estimating apoptosis index.
探讨生存素、Ki-67及凋亡指数在进展期胃腺癌患者中的表达及意义。
采用免疫组织化学SP法检测120例胃腺癌组织中生存素的表达、细胞增殖指数（Ki-67）及凋亡指数（TUNEL）。
120例胃腺癌组织中，59例（49.17%）癌细胞胞质中检测到生存素表达；在淋巴结转移灶中，32例（64.00%）检测到生存素表达；在120例正常胃黏膜基底层中，21例（17.50%）检测到生存素表达。原发肿瘤的平均增殖指数（Ki-67）为7.55%，显著低于淋巴结转移灶的平均增殖指数8.34%。原发肿瘤的平均凋亡指数为1.16%，显著高于淋巴结转移灶的平均凋亡指数0.89%。生存素在淋巴结转移灶中的表达频率显著高于原发性胃腺癌。生存素的表达与组织学类型、浸润深度或淋巴结转移显著相关（P<0.05）。生存素评分与凋亡指数呈负相关（P<0.05），与增殖指数无相关性。
生存素的高表达可能是评估肿瘤分化程度、预测淋巴结转移及估计凋亡指数的参考指标。
