Expression Of Survivin,PTEN,cdx2 And Paxillin Gene In Human Early Gastric Cancer And Their Relations

[Objective] To investigate the expression of Survivin, PTEN, cdx2 and Paxillin in early gastric carcinoma and various kind hyperplastic affection of gastric mucosa and review their relations. To oberve the disparation of the these reagents' double expression in early gastric carcinoma and various kind various kind hyperplastic affection of gastric mucosa and to find its clinicalpathological significance.[Methods] Two hundred and seventeen consecutive cases of various kind proliferative leisions of gastric mucosa and early gastric carcinoma were studied which were surgically or gastroscopilly excised in Liaocheng hospital of Shandong from 1970-2005. All samples were fixed in 10% litmusless formalin and paraffin embedded. The diagnosis and categorization were confirmed by reviewing all archival haematoxylin and eosin-stained sections. The cases included 76 normal gastric mucoma, 54 early gastric carcinoma, 46 incomplete large intestinal metaplasia and 67 low grade intraepithelial neoplasia and 26 high grade intraepithelial neoplasia. Immunohistochemical technique Elivision^TM plus method was used to detect the expression of Survivin, Cdx2, PTEN, Paxillin in these 217 specimens. The positive cells were counted with optical microscope and the data were cofficient using SPSS 13.0 software for windows.[Results] The distribution of Survivin-positive cells were significantly different in low grade intraepithelial neoplasia and high grade intraepithelial neoplasia and their positive ratios were 7.46 % (5/67)and 65.4 % (17/26. we could not observe such expression in the normal gastric mucosa(0/30). Only few cases of incomplete-type intestinal metaplasia expressed positive, The expression of Survivin gene was detected in incomplete-type intestinal metaplasia 5.00%( 1/20). The positive ratios of Survivin expression were 7.46% (5/67) and 65.4%(17/26) in low grade intraepithelial neoplasia and high grade intraepithelial neoplasia,respectively.it was 68.5%(37/54) in early gastric carcinoma ,The Survivin-positive cells were much more in high grade intraepithelial neoplasia and early gastric carcinoma than in normal gastric mucoma, incomplete-type intestinal metaplasia and low grade intraepithelial neoplasia. Contiguous pattern with stretches or gland-ductive pattern with the difference of polarization of gastric gland within early gastric carcinoma. In contrast to the normal gastric mucosa, incomplete-type intestinal metaplasia and low grade intraepithelial neoplasia. Almost all of cases of high grade intraepithelial neoplasia and early gastric carcinoma showed marked increases in Survivin in almost constituent cells. Survivin expression in early gastric carcinoma generally varied with the differentiation of the constituent cells while the positive expressions. Although most poor-differentiated gastric carcinoma invairiably showed Survivin positive intensivly in the majority cells and meanwhile majority of well-differentiated cases expressed feebly, even only some gland cells expressed Survivin-positive faintly. Statistic data showed significant difference between low grade intraepithelial neoplasia and high grade intraepithelial neoplasia(P=0.0000003 < 0.05) . There was significant difference in Survivin-positive between low grade intraepithelial neoplasia and early gastric carcinoma(P=0.0000<0.05) . No significance was found between high grade intraepithelial neoplasia and early gastric carcinoma(P=0.803>0.05). However we could not find significant difference in Survivin-positive between normal gastic mucosa and incomplete-type intestinal metaplasia(P=0.1286>0.05). Normal gastic mucosa and low grade intraepithelial neoplasia(P=0.208>0.05), incomplete-type intestinal metaplasia and low grade intraepithelial neoplasia(P= 0.208>0.05).Cdx2, PTEN, Paxillin were found respectively show positive-expression and their ratio were 72.2%(39/54), 59.2%(32/54) and 38.9%(21/54) respectively in early gastic carcinoma. Significant relations were found between Survivin, Cdx2, PTEN, Paxillin gene and histological types of early gastric carcinoma(P<0.05 ). Significant relations were also found between survivin, PTEN, Paxillin gene proteins expression with the invasive depth of early gastric carcinoma (P<0.05). There was a positive correlation between the three expression and lymph node metastasis(P<0.05) .But no significant difference was found between the expression of Cdx2 and all former items (P>0.05). The expresion ratio of Survivin was positive correlated with the high expression of Cdx2 (r=0.6203,P=0.0000) and negatively correlated with the high expression of PTEN, Paxillin protein(r=-0.3803,P=0.0052; r= -4880, P= 0.0012).[Conclusion] : These data indicated that the diverse expression of survivin, Cdx2, PTEN and paxillin might play certain role in the onset and progression of early gastric carcinoma, for early gastric cancer, positive correlation was indicated between expression of survivin and cdx2 and expression of survivin was negatively correlated with expression of PTEN and Paxillin. Excessive expression of survivn and Cdx2 and defective expression of PTEN and Paxillin may be a index of tumor's prognosis.