【摘要】 目的　检测胃腺癌组织中survivin、ki 6 7基因的表达及凋亡指数 ,探讨它们的相关性及临床意义。方法　应用免疫组织化学方法 ,标记 12 0例进展期胃腺癌组织survivin及ki 6 7,应用TUNEL法检测癌细胞的凋亡指数。结果　survivin在癌细胞及部分正常腺体基底生发层细胞的胞浆有表达。原发灶、淋巴结中转移癌细胞及正常腺体基底生发层细胞的survivin的表达率分别为4 9 17%、6 4 0 0 %和 17 5 0 %。原发灶、淋巴结中转移癌细胞增殖指数分别为 7 5 5 %± 2 99%和8 34%± 2 79% ;凋亡指数分别为 1 16 %± 0 78%和 0 89%± 0 5 4 %。转移至淋巴结中的癌细胞survivin的表达率高于原发灶癌细胞。survivin的表达与肿瘤病理亚型、分化程度及淋巴结转移有关 ;survivin表达评分与肿瘤细胞的凋亡指数呈负相关 ,与增殖指数无明显相关性。结论　survivin表达可能作为评价肿瘤分化程度 ,预测淋巴结转移以及估计凋亡指数的参考指标更多还原

【Abstract】 Objective To investigate the expression and significance of survivin, ki 67 and apoptosis index in patients with advanced gastric adenocarcinoma. Methods Immunohistochemical SP method for survivin expression as well as cell proliferative index (ki 67) and apoptosis index (TUNEL) was conducted on 120 gastric adenocarcinomas. Results The survivin was detected in the cytoplasm of carcinoma cells in 59 (49 17%) of the 120 gastric adenocarcinomas, in 32 (64 00%) of the lymph node metastasis, and in 21 (17 50%) of the 120 basal layer in normal gastric mucosa, respectively. The mean proliferative index (ki 67) in primary tumors was 7 55%, which was significantly lower than the mean proliferative index of 8 34% observed in lymph node metastasis. The mean apoptosis index in primary tumors was 1 16%, which was significantly higher than the mean apoptosis index of 0 89% observed in lymph node metastasis. The frequency of survivin expression was significantly higher in lymph node metastasis than in primary gastric adenocarcinoma. Expression of survivin was significantly correlated with histological subtypes, the depth of invasion, or lymph node metastasis ( P <0 05). There was negative correlation between weighted survivin score and apoptosis index ( P <0 05), but no correlation with proliferative index. Conclusion The high level expression of survivin might be a referenced indicator in evaluating differentiation of tumor and in predicting lymph nodes metastasis and estimating apoptosis index.更多还原