Expression Of Survivin、VEGF、Cox-2in Pterygium And Their Correlation With Experimental Study

Objective:To investigate the expression of Survivin, VEGF, Cox-2in pterygium as well as the correlation among their expression, further explore the pathogenesis, providing the theoretical evidence for the better treatment of pterygium.Methods:The pterygium tissues from32pterygium patients (32eyes) and normal nasal conjunctival tissues from10heterotropia (10eyes) patients who had surgical treatment from June2013to May2014in PUMCH were included in this study. Immunohistochemical S-P staining method was adopted in detecting the expression of Survivin, VEGF, Cox-2in20cases of pterygium and10cases of normal conjunctival tissues. Real-time PCR method was adopted in detecting the amount of Survivin, VEGF, Cox-2mRNA in12cases of pterygium and6cases of normal conjunctival tissues. The results were compared between the pterygium and normal conjunctival tissues. In the pterygium group, the results were further compared between the primary and recurrent status, as well as the preoperative treatment cases and those without such treatment. In addition, the correlation among Survivin, VEGF and Cox2in pterygium was analyzed according to these experimental data.Results:(1) Pterygium epithelium had varying degrees of proliferation. Fibroblasts proliferated actively and increased angiogenesis, as well as inflammatory cell infiltration, were seen in the sub-epithelial tissue.(2) Survivin showed expression in epithelial cells in pterygium, but showed no evidence of it in normal conjunctival specimens. In some pterygium and normal conjunctiva specimens, VEGF and Cox-2expressed in epithelial cells and sub-epithelial tissues. The positive expression rates of Survivin, VEGF and Cox-2in20cases of pterygium were35.0%,75.0%,60.0%, while those in10cases of normal conjunctiva were0,20.0%,10.0%. All the results of immunohistochemical staining and real-time PCR showed the expression of Survivin, VEGF and Cox2in pterygium was higher than that in normal conjunctiva tissues(P<0.05).(3) The positive expression rates of VEGF in primary and recurrent pterygium were66.7%and100.0%. Those of Cox-2were53.3%and80.0%. All the results showed a significant difference between primary and recurrent pterygium (P<0.05). The expression of Survivin showed no significant difference between primary and recurrent pterygium (P>0.05). The preoperative treatment of Triamcinolone Acetonide had no obvious effect on the expression of Survivin, VEGF and Cox-2.(4) The results of immunohistochemical staining showed a significant positive correlation among Survivin, VEGF and Cox2in pterygium (P<0.05).Conclusions:(1)Proliferation of fibroblasts and vessels was seen in pterygium.(2)The overexpression of Survivin, VEGF and Cox-2in pterygium suggested that these markers may be concerned with the development and progression of pterygium.(3) The recurrent pterygium showed a higher expression of VEGF and Cox-2.(4) The significant positive correlation can be found among Survivin, VEGF and Cox2in pterygium, which suggested that there may be synergistic action among the three factors during the occurrence and development of pterygium.