| Objective:The gastric carcinoma is the most common malignant tumors in the digestive system. At present, the mortality of the gastric carcinoma is the second in all of tumors worldwide and the first place of malignant tumors in our country. Therefore, it has important realistic meaning to look for the new method to prevent and cure gastric carcinoma in order to raise the total treatment level of gastric carcinoma. In normal condition, the tissue is sustained through a dynamic balance between the somatic proliferation and apoptosis. And it will lead to malignant transformation of cell if abnomal proliferation or inhibitor of apoptosis is took place. Survivin gene is an inhibitive factor of apoptosis protein, which is a"close"gene in adult normal organization, but being activated to participate in the genesis and growth of tumor. Therefore, it is regarded as a tumoral related agent. On the other hand, it has close relationship between the abnormality of cell period adjustment and control and the genesis and growth of tumor. Studies for cell cycle indicated that the change of regulatory factors will influence the circulation of cell cycle, which will formate tumor if being accelerated. Cyclin D1, as the start factor of the period of cell propagate, has the key function in G1/S transition. There are the relativity between the excessive expression of cyclin D1 and the genesis and growth of various tumors. But currently there is not report about the relationship between the expressions of Survivin and cyclin D1 in gastric carcinoma and regional lymph nodes. In this study we detected the expressions of Survivin and cyclin D1 in gastric carcinoma tissues, regional lymph nodes and normal gastric mucosa by S-P immunohistoch- emical technique, analyzed the relationship between the expressions and the biological behavior of gastric carcinoma and the relationship between the expressions of Survivin and cyclin D1 in gastric carcinoma primary foci and regional lymph node metastases foci, which will provide new thought to clarify the mechanism of genesis and growth of gastric carcinoma, at the same time, reveal the mechanism of propagate and differentiation of the gastric carcainoma cell and guide the clinical treatment.Methods:In this study, we selected 73 samples of gastric carcinoma, 73 samples of first station of lymph node and 73 samples of normal gastric mucosa(around gastric carcinoma>5cm), which proved by pathology. All patients had gastrectomy in the third department of surgery of the 4th hospital of HeBei Medical University from Octobor 2005 to August 2006. All gastric carcinoma clinical records were registered according to gastric carcinoma diagnosis and treatment criterion. The expressions of Survivin and cyclin D1 in gastric carcinoma tissue, first station of lymph node and normal gastric mucosa were detected by S-P immunohistochemical technique in this study. The relationship between the expressions of Survivin and cyclin D1 and the biological behavior of gastric carcinoma were analyzed, including patients'sex, age, tumor location, size, differentiate extent, infiltration depth, differentiate extent, clinical stages and lymph node metastasis etc. And the relationship between the expressions of Survivin and cyclin D1 was studied. The difference for the expressions of Survivin and cyclin D1 was evaluated between the primary foci and the metastases foci in the 44 cases with lymph node metastases among the 73 cases of gastric carcinoma. All data were analyzed by statistics software SPSS 12.0, and P<0.05 was considered significant.Results:1 The positive rates of Survivin were 61.64% in gastric carcinoma tissues, but there were no expressions in normal gastric mucosa. The expressions of Survivin in gastric carcinoma tissues were significantly higher (P<0.01). The positive rates of cyclin D1 were 64.38% in tissues of gastric carcinoma, which were significantly higher than the rates of 13.70% in normal gastric mucosa(P<0.01).2 There was positive correlation between the expressions of Survivin and cyclin D1 in gastric carcinoma tissue (rs = 0.387, P<0.01).3 The expression of Survivin in gastric carcinoma was following: As to the differentiate extent, the poorly differentiated positive expression rate was 74.36%, which was higher than 47.06%, the well and moderately differentiated positive expression rate. The comparison of the two showed significant difference (P<0.01); As to the infiltration depth, the positive expression rate of T3+T4 was 67.19%, which was higher than 22.22%, the expression rate of T1+T2. The comparison of the two shows significant difference (P<0.01); The positive expression rate in clinical stages III-IV is 71.74%, which was higher than 44.44%, the expression rate in clinical stages I-II. The comparison of the two showed significant difference(P<0.05); The positive expression rate of tumors with lymphoid node metastasis was 72.73%, which was higher than 44.83%, the expression rate of tumors without lymphoid node metastasis. The comparison of the two showed significant difference (P<0.05). Survivin expression in gastric carcinoma tissues had no significant relevance to sex, age, tumor location, size or gross type (P>0.05).4 The expression of cyclin D1 in gastric carcinoma was following: As to the differentiate extent, the poorly differentiated positive expression rate was 79.49%, which was higher than 47.06%, the well and moderately differentiated positive expression rate. The comparison of the two shows significant difference (P<0.01). Cyclin D1 expression in gastric carcinoma tissues had no significant relevance to sex, age, tumor location, size, infiltration depth, gross type, clinical stages or lymphoid node metastasis (P>0.05).5 In gastric regional lymph node tissues, the expressions of Survivin and cyclin D1 in the group with lymph node metastasis were respectively 90.91% and 75.00%, but there were no expressions in the group without lymph node metastasis. The expressions of Survivin and cyclin D1 in the group with lymph node metastasis were significantly higher than those without lymph node metastasis (P<0.01).6 In the 44 cases with lymph node metastases among the 73 cases of gastric carcinoma, the expression degrees of Survivin were more powerful in the metastases foci than in the primary foci (P<0.01). The expression degrees of cyclin D1 had not significant difference between the both tissues (P>0.05).Conclusion:1 The expressions of Survivin and cyclin D1 in gastric carcinoma tissues are significantly higher than those in normal gastric mucosa. It shows that Survivin and cyclin D1 act an important role in course of formation of malignant tumors and would be useful molecular marker for assessment of gastric prognosis. There is positive correlation between the expressions of Survivin and cyclin D1 in gastric carcinoma tissue, which shows that the two are in administrative relation and cooperate in the process of gastric carcinoma genesis and growth.2 The expressions of Survivin become significantly higher along with differentiate extent to lower, infiltration depth to deeper, clinical stages to higher, lymph node metastasis. It shows the expressions of Survivin are correlated with growth and prognosis of gastric carcinoma. The expressions of cyclin D1 become significantly higher along with differentiate extent to lower. It shows the expressions of cyclin D1 are correlated with clinical pathology progress of gastric carcinoma. The high expressions of cyclin D1 in gastric carcinoma tissues result in malignant growth of tumor.3 In gastric regional lymph node tissues, the expressions of Survivin and cyclin D1 in the group with lymph node metastasis are significantly higher. It shows the expressions of Survivin and cyclin D1 in gastric regional lymph node tissues unusually are correlated with lymph node metastasis. In gastric regional lymph node tissues, which the high expressions of Survivin and cyclin D1, it is easy to take place lymph node metastasis.4 There is difference between the gastric carcinoma primary foci and the lymph node metastases foci in expression degree of Survivin. It's likely that there is difference between primary foci of gastric carcinoma and lymph node metastatic foci on molecular level. But there is not difference for cyclin D1, which shows that cyclin D1 does not change in the course of metastasis.In conclusion, the abnormal expressions of Survivin and cyclin D1 in gastric carcinoma tissues play important roles in the genesis and growth of gastric carcinoma. The abnormal expressions of Survivin and cyclin D1 in gastric regional lymph node are related to lymph node metastasis. Unite examining the expressions of Survivin and cyclin D1 in gastric carcinoma and regional lymph node has active clinical meaning in prognosticating the growth of gastric carcinoma and raising the accuracy of stage and prognosis. |
