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目的:研究声带息肉、成人型喉乳头状瘤和喉鳞状细胞癌3种疾病中Survivin和PTEN的表达特点,以了解喉鳞状细胞从增生到癌变的可能机制。方法:选取符合临床与病理诊断的声带息肉患者18例、成人型喉乳头状瘤患者10例和喉鳞状细胞癌患者18例,将每个患者的病理蜡块标本各连续切片2张,分别进行Sur-vivin和PTEN免疫组织化学检测。比较致癌基因Survivin和抑癌基因PTEN在这3种疾病同一区域鳞状上皮细胞中的表达差异。结果:声带息肉的Survivin和PTEN阳性率均显著低于喉乳头状瘤和喉鳞状细胞癌(P<0.05),而喉乳头状瘤的Survivin和PTEN阳性率均低于喉鳞状细胞癌,但均没有显著性差异(P>0.05),Sur-vivin和PTEN形成近似声带息肉<成人型喉乳头状瘤<喉鳞状细胞癌的表达趋势。在声带息肉、喉乳头状瘤及喉鳞状细胞癌3种疾病中,PTEN的阳性率均显著低于Survivin(P<0.05)。结论:Survivin和PTEN在喉良性增生性疾病的鳞状细胞中部分表达,而在良性和恶性肿瘤中过度表达,体现出随恶性程度增加而逐渐升高的表达趋势,Survivin和PTEN虽然功能相反,但作用机制不同,非对立消长关系,PTEN体现出一定的竞争表达特点,并从属于Survivin的表达,两者的统一部分决定了喉鳞状细胞的恶变程度。
Objective: To investigate the expression characteristics of Survivin and PTEN in vocal cord polyps, adult laryngeal papilloma and laryngeal squamous cell carcinoma in order to understand the possible mechanisms of proliferation and carcinogenesis of laryngeal squamous cells. METHODS: Eighteen patients with vocal cord polyps, 10 adult patients with laryngeal papilloma and 18 patients with laryngeal squamous cell carcinoma were selected in accordance with clinical and pathological diagnosis. Sur-vivin and PTEN immunohistochemistry were performed. The differences in expression of Survivin and PTEN were compared in squamous epithelial cells in the same region of these three diseases. Results: The positive rates of Survivin and PTEN in vocal cord polyps were significantly lower than those in laryngeal papilloma and laryngeal squamous cell carcinoma (P<0.05). The positive rates of Survivin and PTEN in laryngeal papilloma were lower than those in laryngeal squamous cell carcinoma. However, there was no significant difference (P>0.05). Sur-vivin and PTEN formed an approximate vocal cord polyp < adult-type laryngeal papilloma or laryngeal squamous cell carcinoma. In vocal cord polyps, laryngeal papilloma and laryngeal squamous cell carcinoma, the positive rate of PTEN was significantly lower than that of Survivin (P<0.05). CONCLUSIONS: Survivin and PTEN are partially expressed in squamous cells of benign proliferative diseases of the larynx, but are overexpressed in benign and malignant tumors, showing a trend of increasing expression as the degree of malignancy increases. Although Survivin and PTEN function in opposite directions, However, the mechanism of action is different and non-contradictory and long-lasting. PTEN embodies certain characteristics of competitive expression and is subordinate to the expression of Survivin. The unity of the two factors determines the degree of malignant transformation of laryngeal squamous cells.