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目的探讨鄱阳湖区域日本血吸虫病患者Survivin、p53、E-cadherin的表达及其临床病理学意义。方法选择鄱阳湖区域确诊为慢性与晚期血吸虫病患者(151例)的胃黏膜标本(其中萎缩性胃炎49例,胃黏膜异形增生30例,不完全性大肠上皮化生34例,胃癌38例)。应用组织芯片和免疫组织化学S-P法检测Survivin、p53、E-cadherin在正常黏膜、癌前病变、胃癌组织中的表达。结果 Survivin蛋白在正常胃黏膜组织壁细胞可见阳性表达,而其他细胞几乎无表达。Survivin蛋白阳性表达率在萎缩性胃炎、不完全性大肠上皮化生、异型增生和胃癌各组分别为51.02%、58.82%、66.67%、86.84%,各组织间比较差异有统计学意义(P<0.05);p53蛋白阳性表达率在正常胃黏膜、萎缩性胃炎、不完全性大肠上皮化生、异型增生和胃癌各组分别为1.32%、16.33%、58.82%、76.67%、92.11%,各组织间比较差异有统计学意义(P<0.05);E-cadherin蛋白在正常胃黏膜表达率为100.00%,在萎缩性胃炎、不完全性大肠上皮化生、异型增生和胃癌各组胃黏膜组织中阳性率分别为83.67%、76.47%、63.33%、26.31%,各组织间比较差异有统计学意义(P<0.05)。Survivin、p53、E-cadherin蛋白表达与胃癌的组织分化程度、浸润程度、淋巴结转移及pTNM分期有关(均P<0.05)。结论 Survivin、p53、E-cadherin蛋白可能参与血吸虫患者胃癌病变的发生发展,可作为较理想的标志物用于胃癌的早期诊断和转移预后的预警。
Objective To investigate the expression of Survivin, p53, E-cadherin and their clinicopathological significance in schistosomiasis japonica in Poyang Lake area. Methods Gastric mucosa samples (including 49 cases of atrophic gastritis, 30 cases of gastric mucosal dysplasia, 34 cases of incomplete colorectal metaplasia and 38 cases of gastric cancer) were selected from 151 cases diagnosed as chronic and advanced schistosomiasis in Poyang Lake area. . The expression of Survivin, p53 and E-cadherin in normal mucosa, precancerous lesions and gastric cancer tissues was detected by tissue microarray and immunohistochemical S-P method. Results The positive expression of Survivin protein in normal gastric mucosa parietal cells, while the other cells almost no expression. The positive expression rate of Survivin protein was 51.02%, 58.82%, 66.67%, 86.84% in atrophic gastritis, incomplete colorectal metaplasia, dysplasia and gastric cancer respectively, there was significant difference between the various tissues (P < 0.05). The positive expression rates of p53 protein in normal gastric mucosa, atrophic gastritis, incomplete intestinal metaplasia, dysplasia and gastric cancer were 1.32%, 16.33%, 58.82%, 76.67%, 92.11% (P <0.05). The expression rate of E-cadherin protein in normal gastric mucosa was 100.00%. In atrophic gastritis, incomplete colorectal metaplasia, dysplasia and gastric mucosa The positive rates were 83.67%, 76.47%, 63.33% and 26.31%, respectively. There was significant difference among different groups (P <0.05). The protein expression of Survivin, p53 and E-cadherin correlated with the degree of tissue differentiation, infiltration, lymph node metastasis and pTNM stage (all P <0.05). Conclusions Survivin, p53 and E-cadherin may be involved in the development of gastric cancer in schistosomiasis patients, which may be an ideal marker for early diagnosis of gastric cancer and prognosis of metastasis.