Expression And Pathobiological Significance Of Survivin, P53 And Bcl-2 Proteins In NSCLC

Objective:To study the expression and clinicopathological significance of survivin, p53 and Bcl-2 in Non-small Cell Lung Cancer (NSCLC).Methods:Expressions of survivin, p53 and Bcl-2 in 89 cases with complete follow-up data were detected by SP immunohistochemical method,while all 89 cases were patients with NSCLC. The relationship between these proteins and clinicopathologic features was analyzed by X2 test and Spearman's rank correlation analysis. The Kaplan-Meier method and the two-tailed log-rank test were also used to evaluate the prognosis in patients with NSCLC.Results:(1) Positive rates of survivin, p53 and Bcl-2 proteins were 66.3%,57.3%, 44.9%, respectively. The expression level of three proteins in NSCLC was significantly higher than that in nontumorous tissue (p<0.05), and no expression of survivin and p53 was observed in nontumorous tissue. (2)The immunopositive rates of survivin, Bcl-2,and p53 in adenocarcinoma were 47.6%(20/42),28.6%(12/42),59.5% (25/42),respectly while 74.5%(35/47),59.6%(28/47),55.3%(26/47) respectly in squamous cell carcinoma.The differences of survivin, Bcl-2 between adenocarcinoma and squamous cell carcinoma were significant(P<0.05),while the difference of p53 showed no significance. (3) Survivin expression was found to have significant correlation with p53 and Bcl-2 expression by Spearman's rank correlation analysis,both were positive correlation. There were 41 cases, in which the expression of survivin and p53 were both positive, while both negative in other 24cases (r=0.443, P<0.05). Meanwhile, there were also 30 cases,in which survivin expression and Bcl-2 expression showed both positive while both negative in other twenty-four cases(r=-0.245, p< 0.05).No evidence was found for an association between expression of bcl-2 and p53.(4) It was revealed that 5-year overall survival rate with negative expression of survivin, p53 and Bcl-2 was higher than that with positive expression.Conclusion:(1) In this study,we find the positive rates of survivin, p53 and Bcl-2 in NSCLC tissue are higher than that in nontumorous tissue, and their aberrant expressions are related to the tumorigenesis of NSCLC.(2) We also find the positive expression of survivin and Bcl-2 in squamous cell carcinoma is higher than that in adenocarcinoma.Besides, survivin and P53 show more positive expression in StageⅢandⅣNSCLC than StageⅠandⅡ. (3) Expression of survivin is correlated with p53 and Bcl-2 positively while no correlation between p53 and Bcl-2 is detected. (4) Expression of survivin, p53 and Bcl-2 are correlated with the prognosis of NSCLC patients, and better prognosis is found in negative -expression cases than in positive ones which suggest that union detection of survivin, p53 and Bcl-2 may be helpful for diagnosis and prognosis judgment of NSCLC.