| Background and Objectives:Gastric cancer is one of the most common gastrointestinal cancer, the incidence rate in the second tumor, the mortality rate highest in the first place, China is one of the areas of high incidence of gastric cancer, the annual mortality rate of 16 /10 million, high incidence of 60/10 million. In other countries, in stomach cancer mortality in the different races, different countries and different periods of the same region there was significant difference between districts with high incidence in Japan, South Africa, followed by Eastern Europe. Gastric cancer is the serious threat to human life and health. How to effectively prevent the development of gastric cancer has been the focus of scholars to digest sector. Many studies show that the incidence of gastric cancer is a slow process, some patients may have experienced from the normal mucosa, chronic superficial gastritis (chronic Superficial gastritis, CSG), chronic atrophic gastritis (chronic atrophic gastritis, CAG), chronic atrophic with mild dysplasia, chronic atrophic moderate dysplasia sexual partners, sexual partners of severe chronic atrophic hyperplasia, cancer multi-step process. This process can take several years or decades. Numerous genetic and molecular changes in the process of accumulation is closely related with this evolution. Currently, people molecular mechanism of gastric cancer is not clearly understood. exploring the molecular mechanism of control is a hot topic of the study and application.Studies have shown that inhibition of apoptosis during the formation of gastric cancer is an important mechanism through which the life of a genetic mutation in cells caused by the occurrence of gastric cancer is extended. Cells (apoptosis) is determined automatically by a gene active during the end of life, determined by the genetic mechanism of regulation of strict procedures, also known as programmed cell death by apoptosis in the process of apoptosis-promoting factor and the common inhibitor regulation Survivin is an apoptosis suppressor gene, located on chromosome 17q25 is not high on the stability of its encoded protein Survivin is made up of 142 amino acid protein with molecular weight 16.5kD to homodimer form, expressed in the cell cycle G2/M phase. Molecular weight of the smallest ever found, the role of one of the strongest inhibitor of apoptosis, regulate the cell cycle and other biological activity. The biological function of survivin inhibits apoptosis mainly through the pathway downstream of caspase-3, caspase-7 to combat paclitaxel, Fas, Bax, cytochrome and caspase-induced apoptosis, against the G2/M phase cells induced by mitosis promoting abnormal proliferation of transformed cells, eventually leading to the occurrence of cancer; also promote tumor angiogenesis, to provide for the growth of tumor invasion. Survivin can be selectively expressed in malignant tissue, but not the expression of adjacent normal tissues, and can promote malignant transformation of cells and inhibit apoptosis,which is an important factor in some of malignancy. Increased the expression of Survivin in tumor development occurs very early, and with the expression of tumor growth invasion it gradually increased,because Survivin inhibits apoptosis of tumor cells, promote tumor development.The purpose of this study is to determine the survivin protein in chronic superficial gastritis, chronic atrophic gastritis and gastric dysplasia and the expression level of survivin protein in gastric cancer development in the role of molecular biology, and early gastric cancer diagnosis, assessment of prognosis, recurrence, and gene therapy to determine a new way.Materials and methods:1. Collection of Gastroenterology, Nanfang Hospital, Southern Medical University, and the People's Hospital of Foshan, Sanshui District, digestive endoscopy room diagnosis and pathologically confirmed cases. Into chronic superficial gastritis, chronic atrophic gastritis, chronic atrophic gastritis with mild dysplasia, chronic atrophic gastritis with moderate dysplasia, gastric cancer, the 5 groups, each with 40 cases. Among them, chronic superficial gastritis group,29 males and 11 females, mean age (51.10±13.63) years; chronic atrophic gastritis group,28 males and 12 females, mean age (52.35±14.62) years; chronic atrophic gastritis with mild dysplasia,30 males and 10 females, mean age (52.13±14.47) years; chronic atrophic gastritis with moderate dysplasia,31 males and 9 females, mean age (54.60±12.26) years; gastric cancer group,29 males and 11 females, mean age (58.75±15.20) years. Age and gender between the groups was statistically no significant difference among the groups were comparable.2. All tissue specimens were confirmed by 10% neutral formalin-fixed, wax dipped graded alcohol dehydration, conventional embedded sections, baking sheet, HE staining. survivin immunohistochemical Fuzhou step by Biotechnology Development Co., Ltd provide new kit instructions. Positive film using a known as a positive control. Antibody was replaced with PBS as a negative basic controls.Results:1.40 patients of Chronic superficial gastritis group,, Survivin expression in 3 cases, the average score of 0.075±0.267, the positive rate of 7.5%;40 patients of chronic±cases atrophic gastritis group,, Survivin expressionin 18 cases, the average score of 0.600±0.744, The positive rate of 45%;40 cases of chronic atrophic gastritis with mild dysplasia, Survivin positive expression in 30 cases, the average score of 2.075±1.980, the positive rate of 70%; 40 patients of chronic atrophic gastritis with moderate dysplasia group,, Survivin expression in 38 cases, the average score of 4.225±2.402, the positive rate of 95%; 40 cases of gastric cancer, Survivin expression in 39, the average score of 5.750±3.614, the positive rate of 97.5%.2.40 cases of gastric cancer, Survivin expression in 39 cases, including weakly positive (+)inl9 cases, moderately positive (++) in 10 cases, strongly positive (+++) in 10 cases. According to histological type (and differentiation),2 cases of adenocarcinoma,1 cases of Survivin expression weak positive (+),1 cases of moderate positive (++) with a mean score of 2.500+0.707; moderately differentiated adenocarcinoma in 8 cases,2 cases of Survivin expression weak positive (+),3 cases of moderate positive (++),3 cases of poorly positive (+++) in 3 cases, the average score of 8.750±3.495; differentiated adenocarcinoma in 22 cases, Survivin expression was negative in 1 case, weakly positive (+)in 11 cases, moderately positive (++) in 4 cases, strongly positive (+++)in 7 cases, the average score of 5.522+3.654; adenocarcinoma in 2 cases, weakly positive (+) in 1 case,moderately positive (++) in 1 cases, the average score of 3.200±0.837; signet ring cell carcinoma in 5 cases, weakly positive (+)in 3 cases, moderately positive (++) in 2 cases, the average score of 6.000±0.000.Conclusion:1.Survivin in chronic atrophic gastritis group (18,45%), chronic atrophic gastritis with mild dysplasia (25,75%), chronic atrophic gastritis with moderate dysplasia (38,95%), stomach (39,97.5%) in the positive rate was significantly higher than that of chronic superficial gastritis (3,7.5%), the difference was statistically significant (p <0.05).2. Gastric cancer (39,97.5%) and chronic atrophic gastritis with moderate dysplasia (38,95%) expression was no significant difference (p=0.252).3.Survivin positive expression in gastric cancer with sex and tumor size and the differentiation of tissues no significant relationship (t=0.311 p=0.785; t=0.413 p =0.682; F=0.734 p=0.575). |
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