Expression Of Survivin,VEGF And Tumor Cells Spread In Distal Intramural To Rectal Cancer

[BACKGROUND&OBJECTIVE]The ones who have sphincter preservation for rectal cancer have a better quality of life than those haven't. The rate of sphincter-saving is gradually increasing, but the rate of recurrence at anastomosis after operation for rectal cancer reaches from 5 percent to 15 percent. It is important for surgeons to choose the mode of operation and identify where the distal bowel should be resected. The regularity of rectal cancer invasion and metastasis is an important evidence of selecting the mode of operation. At present, there are different opinions about the safe distal clearance margin of rectal cancer. Some authors believed it was safe enough to resect 1.00cm distal bowel of rectal cancer. While 3.00cm distal to rectal cancer is generally accepted. Comparing with the conventional method of hispathology, the method of molecular pathology is more sensitive to measure the markers of tumor. Furthermore it can detect abnormal cells and predict where it will recur after operation. This study was designed to explore the molecular margin of distal intramural protein expression of survivin, VEGF (vascular endothelial growth factor ,VEGF) in rectal cancer , and to further clarify the required distal margin of radical surgery for rectal cancer.[METHODS]We detected the protein expression of survivin, EVGF in specimens which had been collected from Feb.2004 to Apr. 2005 by the method of strept avidin-biotin immunostaining. From them, thirty-nine both survivin and EVGF positive specimens were selected. Microscopic distal intramural expression was examined by survivin/VEGF-immunohistochemistry (survivin/VEGF-IHC),comparing with conventional hematoxylineosin (HE) staining in consecutive slice. Tissue shrinkage ratio, comparing the distal clearance margin measured in fresh specimens to that measured in slice after fixed in each case ,was used to convert macroscopically...