Gallbladder And Precancerous Lesions Survivin Expression And Clinical Significance

Gallbladder refers to primary malignant tumour of the gallbladder. Look fromhistological classification, with highest proportion of adenocarcinoma (>80%),followed by cancer, mixed carcinoma and undifferentiated carcinoma. Because of itshigh degree of malignant, easy to move, difficult to early detection, early is notsensitive to chemotherapy drugs, etc, and its preoperative diagnosis of gallbladderpatients after curative effect difference in hepatocellular carcinoma and pancreaticcancer. Gallbladder refers to primary malignant tumour of the gallbladder. Look fromhistological classification, with highest proportion of adenocarcinoma (>80%),followed by cancer, mixed carcinoma and undifferentiated carcinoma. Because of itshigh degree of malignant, easy to move, difficult to early detection, early is notsensitive to chemotherapy drugs, etc, and its preoperative diagnosis of gallbladderpatients after curative effect difference in hepatocellular carcinoma and pancreaticcancer. Gallbladder is not rare, in recent years, statistics show that incidence hasincreased, gallbladder accounted for about20%of all gastrointestinaladenocarcinoma, women three times the incidence of the male, age50or aboveaccounted for5%to9%. Gallbladder causes need to be researched, the common viewis thought to be associated with chronic cholecystitis and gallbladder stonestimulation on for a long time, because80%of the patients with gallbladder withgallbladder stones, and with the increase of the stone diameter, the probability ofcancer also increase; Another view is that: biliary cholesterol and bile salts in theconditions of infection, the gallbladder mucosa metaplasia degeneration, long andproduce canceration. Main clinical symptoms include pain, jaundice and angular,gallbladder area mass etc. So far, the treatment of gallbladder rely mainly on surgery,medical treatment is generally poor curative effect. In accordance with the extent of tumor invasion, its curative effect also different, confined to the mucosa andsubmucosa of the gallbladder after surgical removal of the prognosis is good, such ascancer has invaded and full thickness, and spread to the bile ducts, or have a liver anddistant metastasis, and can only rely on chemotherapy, radiation therapy, andtreatment of traditional Chinese medicine.Survivin is1997by Ambiosini etc in the human genome library was firstisolated gene in the hybrid filter, also known as Survivin or survival. Belong toapoptosis inhibition protein family members.(4) apoptosis inhibition of protein inhumans include NAIP. CIAP-1, cIAP-2, XIAP, LP-2, Livin, Apollon, andSurvivin. Survivin gene full15KB, aimed at17q25.3, including four three exonsand introns, consists of142amino acid and N-at the end of a single baculovirusapoptosis suppressor repetitive sequence function composition, relative molecularmass is16.5KD, Cys-Pro-three amino acids Trp fragment inserted this structurecan be divided into two parts: the lack of carboxyl terminal auxiliary ubiquitindegradation of IAPs-Caspase complex ring finger structure, instead of a a-42amino acids long spiral motif, is necessary, microtubules in combination withcombining a spiral structure and cell division microtubules, inhibit apoptosis.Given Survivin is widely expressed in almost all common human malignant tumortissues, and almost undetectable in normal adult tissue, Survivin is expected tobecome the new tumor markers, used for the diagnosis and differential diagnosis oftumors in the identification of benign and malignant, highly expression of Survivin inthe gallbladder, gallbladder prompt detection of the expression of Survivin proteincan serve as a powerful auxiliary means for diagnosis.Objective:1. Comparison of Survivin in the gallbladder and the precancerous lesions in theexpression difference is statistically significant;2. Comparison of Survivin in thegallbladder and precancerous lesions in the activity, and then discusses the role ofSurvivin gene in gallbladder occurrence and development.Methods:Collected in June2000to August2000, baoding second hospital, chengdemedical college affiliated hospital, Beijing university people’s hospital treated cases, 95cases of gallbladder and precancerous lesions in surgery, male,45cases, female50cases; Aged40~68, an average of54years old;35cases gallbladder, gallbladderadenoma25cases,35cases of gallbladder cholesterol polyps. All specimens wereconfirmed by pathological histology. Operation method: the gallbladder excision+expand treated30cases, cholecystectomy60cases, PTCD palliative surgery in5cases.35cases of gallbladder and SP immunohistochemical method the expression ofSurvivin in60cases of precancerous lesions;2. The PCR detection of Survivin geneexpressed in precancerous lesions of gallbladder.Results:Survivin gene expression in the gallbladder and precancerous lesions hadsignificant difference (P <0.05); Survivin gene expressed in gallbladder activity isgreater than its expression in front of the gallbladder lesions in the activity.Conclusion:Survivin gene for those precancerous lesions of gallbladder can progress toprovide a reference biological indicators, further to different degree of pathologicalhistology diagnosis of gallbladder carcinoma cases of lesion before group analysis,according to the experimental results obtained, in-depth understanding gallbladderprecancerous lesions.