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目的 探讨Survivin基因的表达在肺癌发生、发展中的作用及其与Bax、Bcl 2蛋白表达的相互关系。方法 对 12例正常支气管粘膜上皮、9例不典型增生、3 4例肺癌及 12例淋巴结转移癌石蜡切片组织 ,应用原位分子杂交法检测SurvivinmRNA的表达 ;用免疫组织化学链霉菌抗生物素蛋白 过氧化酶法 (S P法 )检测Bcl 2、Bax蛋白的表达。结果 肺癌、淋巴结转移癌中SurvivinmRNA阳性率分别为 61.76%及 91.67% ,显著高于正常支气管粘膜上皮及不典型增生中的阳性率16.7%及 3 3 .3 % (P均 <0 .0 5 ) ;低分化、中分化肺癌中阳性率 88.89%、75 .0 0 %较高分化 11.11%明显升高 (P均 <0 .0 1)。TNM分期Ⅲ期病例中SurvivinmRNA表达阳性率 93 .3 %高于Ⅰ +Ⅱ期病例的 3 6.8% (P <0 .0 1)。SurvivinmRNA表达与Bcl 2蛋白表达呈正相关 (P <0 .0 1)结论 Sur vivin基因在非小细胞肺癌中表达上调 ,提示其通过抑制细胞凋亡 ,在肺癌癌变发生、发展中起重要作用 ,可能成为肺癌基因治疗的新靶点 ,其阳性表达亦预示肿瘤有较高的侵袭性和不良预后 ,Sur vivin基因与凋亡抑制基因Bcl 2的共同表达可能在肺癌中起协同作用。
Objective To investigate the role of Survivin gene in the development and progression of lung cancer and its relationship with Bax and Bcl 2 protein expression. Methods Survivin mRNA was detected by in situ hybridization in 12 cases of normal bronchial mucosa epithelium, 9 cases of atypical hyperplasia, 34 cases of lung cancer and 12 cases of lymph node metastatic carcinoma. The expression of Survivin mRNA was detected by immunohistochemical streptavidin Peroxidase method (SP method) was used to detect the expression of Bcl 2 and Bax protein. Results The positive rates of Survivin mRNA in lung cancer and lymph node metastasis were 61.76% and 91.67% respectively, which were significantly higher than those in normal bronchial mucosa epithelium and atypical hyperplasia (16.7% vs 33.3%, P <0.05) ; The positive rate of poorly differentiated and moderately differentiated lung cancer was 88.89%, 75.O0% higher differentiation 11.11% was significantly higher (P all <0.01). The positive rate of Survivin mRNA in stage Ⅲ TNM was 93.3% higher than that in stage Ⅰ + Ⅱ 36.6% (P <0.01). Survivin mRNA expression was positively correlated with Bcl-2 protein expression (P <0.01) Conclusion Survivin gene is up-regulated in non-small cell lung cancer, which suggests that Survivin gene may play an important role in carcinogenesis and progression of lung cancer by inhibiting apoptosis. As a new target of gene therapy for lung cancer, its positive expression also indicates that the tumor has high invasiveness and poor prognosis. The co-expression of Survivin gene and apoptosis-inhibiting gene Bcl 2 may play a synergistic role in lung cancer.