The Expression Of Survivin And P53 Protein In Pterygium And Its Effection To Cell Proliferation And Apoptosis

Objective: (1) To study the expression of survivin and P53 in the primary and recurrent Pterygium. (2) To study the relationship of them with proliferative and apoptotic status of pterygium.Methods: The expression of survivin,P53 and proliferating cell nuclear antigen( PCNA ) in 20 primary pterygium ,10 recurrent pterygium and 10 normal conjunctiva was assessed by immunohistochemical method. PI was detected by PCNA positive expression and AI was detected by TUNEL method.Results:(1)Seven of the 20 primary(35%) and four of the ten recurrent pterygia specimens (40%) were positive for Survivin expression,which is higher in the normal conjunctiva(0%) . Eight of the 20 primary(45%) and five of the ten recurrent pterygia specimens (50%) were positive for abnormal P53 expression,which is higher in the normal conjunctiva(0%) .There was no difference between the groups primary and recurrence.(2) The expression of survivin clearly segregated with p53-positive pterygium as compared with p53-negative cases [8 of 14cases (57.14%) versus 3 of 16cases (15.2%)]. The x~2 analysis confirmed a highly statistically significant correlation between survivin and p53 expression.(3) The mean AI in primary (61.100±5.9374) % and recurrent (58.600±4.1687) % pterygium which was significantly lower than themean AI in normal conjunctiva(81.300±6.2370)%. The mean PI in primary (24.020±3.9677)% and recurrent(22.044±3.8688)% pterygium which was significantly higher than the mean PI in normal conjunctiva (11.780±2.2968) %. (4) The mean AI in survivin-positive pterygium was (55.182±3.9955),which was significantly lower than the mean AI of (63.211±3.7944) observed in survivin-negative pterygium. The mean PI in survivin-positive pterygium was (27.109±2.8360) which was significantly higher than the mean PI of (20.968±2.6909) observed in survivin-negative pterygium.Conclusion: These results support a model where pterygia development is a result of disruption of the normal process of apoptosis and proliferation occurring in conjunctiva. The disruption is probably due to the abnormal expression of Survivin and P53.