The Expression And Significance Of Survivin And Caspase-3in Vulvar Squamous Cell Carcinoma

Objective1. This study was conducted to investigate the expression and relationship ofSurvivin protein and Caspase3protein in squamous cell carcinoma of the vulva, vulvarintraepithelial neoplasia, vulvar intraepithelial non tumor lesions and normal vulvarepithelium, and analyze its significance.2. This study was conducted to investigate the relationship between Survivin andCaspase3’s protein expression and the different clinical stage, different pathologicalgrading and the different patients’ age of the squamous cell carcinoma of the vulva.3. This study was conducted to investigate the possible role of Survivin protein andCaspase3protein paly in the pathogenesis of vulvar squamous cell carcinoma.Method1. The36vulvar squamous cell carcinoma cases,which were surgical removalled andconfirmed by pathology in jinan military region general hospital and shandong provincialhospital from January2004to June2012, collected as experimental group（21cases ofhigh differentiation,7cases of differentiation in vulvar squamous cancer,8cases of poorlydifferentiated vulvar squamous carcinoma; According to the clinical stage of FIGO2009standards, there are23cases of stageⅠtoⅡ,13cases of stageⅢ to Ⅳ; Patients’ age was47to78-year-old, median age58years old）；The control group were selected in thesame period and confirmed by pathology, which including3cases of vulvar intraepithelialneoplasia,30cases of vulvar intraepithelial neoplasia (whichi including15cases of vulvarsquamous cell hyperplasia and15cases of vulvar sclerosing moss), and line due to genitaltrauma, vaginal laceration of surgery and removal of normal vulvar skin tissues of15cases.The above cases before the samples are without radiation and chemotherapy.2. By S-P immune histochemical method testing organizations in Survivin proteinand Caspase-3protein positive expression. Methods immunohistochemical results: Survivin protein is mainly located in cytoplasm, a few appear in the nucleus, cytoplasm inyellow or tan particles as positive staining, and Caspase3protein in cytoplasm and nuclei,cytoplasm or within the cell nucleus appeared yellow or tan granule for positive staining.Fromowitz half quantitative classification method is used in high power field of vision forcounting under x40each film, according to the number of positive cells and the cellshading depth of particles in the expression of Survivin and Caspase-3protein judgegrading, specific method is: Each film under at high magnification vision for x40randomly selected10field of vision, in every view count100cells, count the positiveexpression of cell number, and then compute the vision of positive, positive rate inaccordance with this method for every view, at last the10view of average positive rate isthe percentage of positive cells,then method according to the following points:(1) thepositive expression cells﹤10%, O points,(2) the positive expression cells number10~25%, and1minute,(3) the positive expression cells count,26~50%, two points,(4)positive expression cells number51to80%,3points,(5) positive expression cells isgreater than80%,4points; Positive expression cells the color depth of the particles,namely cell staining intensity scoring method is as follows: basic not coloring for O, lightyellow for1minute, yellow to2points, tan for the three points, at last both scoremultiplied,0is divided into the negative (-), and1~4divided into weakly positive (+),5~8are divided into the positive (++),9~12can be divided into strong positive (+++).3. Statistical methods: cases of vulvar intraepithelial neoplasia group only3cases, thenumber of cases too little, not enough to statistical analysis, so this set of data out, only tothe remaining three sets of data calculation and analysis. Data analysis SPSS17.0statisticalsoftware for processing, comparison between the two groups using line by a list of chisquare test, the correlation between the two variables using the Spearman rank correlationanalysis, in alpha=0.05, P <0.05for statistical significance.Result1. Survivin protein positive expression rate in vulvar squamous cell carcinoma groupwas66.67%, in the positive expression rate of vulvar squamous cell hyperplasia group was26.67%, vulvar sclerosing moss group the positive expression rate was33.33%, allnegative expression in normal vulvar epithelial group, the positive expression rate was0%.Vulvar squamous cell carcinoma of the set of positive rate and vulvar squamous cellhyperplasia and vulvar sclerosing moss group positive differences were statisticallysignificant, the positive rate of vulvar squamous cell carcinoma group and normal vulvarepithelium of positive difference is statistically significant, sample rather vulvar intraepithelial neoplasia lesions and normal vulvar epithelium of positive difference is notstatistically significant, vulvar squamous cell hyperplasia compared with sclerosing moss,insignificant difference.2. In vulvar squamous cell carcinoma group, Survivin protein expression in stage Ⅰto Ⅱ positive rate was52.17%, the stage Ⅲ to Ⅳ positive expression rate was92.31%,the two comparative differences statistically significant, namely, Survivin protein positiveexpression rate of vulvar squamous cancer increases with the increase of clinical stage;Survivin protein positive expression rate of vulvar squamous cell carcinomas in highdifferentiation was52.38%, vulvar squamous cell carcinomas in the differentiation of thepositive expression rate was71.43%, vulvar squamous cell carcinomas in lowdifferentiation in the positive expression rate is100%, differentiation of high and lowcomparative differences statistically significant, namely, Survivin protein positiveexpression rate of vulvar squamous cell carcinomas of the pathological classification ofhigher and lower; Patients younger than58cases, Survivin protein positive rate was61.11%, age is greater than, equal to the58cases, Survivin protein positive rate was72.22%, no statistically significant difference between them, namely Survivin proteinpositive expression has nothing to do with vulvar squamous carcinoma patient’s age.3. Caspase3protein in vulvar squamous cell carcinoma group and the positiveexpression rate of30.56%, group in vulvar intraepithelial neoplasia disorders (positiveexpression rate was86.67%, expressed in normal vulvar epithelium of positive rate was93.33%. Vulvar squamous carcinoma group, the positive expression rate of sample withvulvar intraepithelial neoplasia lesions in the positive expression rate of the difference hasstatistical significance, the positive expression rate of vulvar squamous cell carcinomagroup and normal vulvar epithelial group the positive expression rate of difference isstatistically significant, rather vulvar intraepithelial neoplasia lesions and normal vulvarepithelial group’s difference is not statistically significant.4. Group in vulvar squamous cell carcinoma, according to a2009FIGO clinical stage,Caspase3stage in Ⅰ to Ⅱ protein positive expression rate was43.48%, the stage Ⅲ toⅣ positive expression rate was7.69%, comparing differences between does not havestatistical significance, namely the Caspase-3protein positive expression has nothing todo with the clinical stage vulvar squamous cell carcinomas; Caspase3protein positiveexpression rate of vulvar squamous cell carcinomas in high differentiation was47.62%,vulvar squamous cell carcinomas in the differentiation of the positive expression rate was 14.29%, no positive expression in vulvar squamous cell carcinomas in low differentiation,differentiation of high and low, statistically significant difference, namely the Caspase-3protein positive expression increased with the increase of vulvar squamous cell carcinomasof the pathologic stage; Patients younger than58cases, Caspase-3protein positiveexpression rate was38.89%, greater than, equal to the58cases, Caspase-3proteinpositive expression rate was22.22%, no statistically significant difference between them,namely the lack of Caspase3protein expression and vulvar squamous carcinoma patientsregardless of age.5. In vulvar squamous cell carcinoma cases, Survivin protein and Caspase3proteinpositive expression showed a negative correlation,r=-0.361.Conclusion1. Survivin protein in vulvar squamous cell carcinomas and its high expression isclosely related to the clinical stages, pathology classification, hints of Survivin proteinincreased destroyed the balance of vulvar squamous cell apoptosis, promote its abnormalproliferation and malignant transformation, resulted in the occurrence and progress ofvulvar squamous cell carcinomas.2. Caspase3protein expressed in vulvar squamous carcinoma of the middle andlower, and its closely related to pathological grading. Caspase3protein cut leads toapoptosis pathway, the expression of abnormal proliferation and progression of vulvarsquamous epithelial cells caused cancer.3. Survivin protein and Caspase3protein expression in vulvar squamous cellcarcinomas of the negative correlation, Survivin can inhibit Caspase3prompts to blocknormal cellular apoptosis, the two work together to promote the occurrence of vulvarsquamous cell carcinomas.