The Expression Of Survivin And Its Significance In Salivary Adenoid Cystic Carcinoma

Objective:Salivary adenoid cystic carcinoma (SACC) is a malignant tumor frequently seen in the minor salivary glands of oromaxillo-facial region. At the early stage, this kind of tumor is not easily discovered and characterized by its hidden growth along the nerve and blood vessels of surrounding tissues, patient's insensitivity to pain, and its metastasis through blood vessels. At present, conventional cures such as chemo and radiotherapy have not produced desired effect in treating this kind of tumor, and exairesis cannot eradicate it. Consequently, neither combined therapy nor long-term therapy can produce desired effect, which has greatly impaired human health. Therefore, experts in oral and maxillofacial surgery and oncology take it as their objective to deeply investigate the bionomics of SACC and actively explore the desired cures for it. Many scholars both at home and abroad, through comparison and screening, hold that gene therapy will probably become a radical cure for SACC; and that it has become the focus of research both at home and abroad to deeply investigate bionomics of SACC, explore its mechanism from the perspectives of gene and protein level, and search for the biological markers related to the occurrence, development and prognosis of SACC.Like other kind of tumor, SACC also has the bionomics of abnormal proliferation and obvious insufficient apoptosis of tumor cells. Now the research into regulatory mechanism pertaining to the apoptosis of tumor cells is in full swing, and all kinds of genes checking apoptosis have discovered successively. Survivin is a kind of gene which has a very effective regulatory function, and it was first separated by Altieri of Yale University in 1997. It has the following major functions: 1) check apoptosis; 2) promote proliferation and differentiation of cells ; 3) regulate cell cycle; and 4) promote Angiogenesis. At present, Survivin, as a kind of labelling oncogene, is frequently used in the research related to malignant tumors. But are there synthesis and expression of Survivin in SACC? And what is the function and significance of Survivin in the occurrence and development of SACC? So far no report about the research has been made both at home and abroad. This research attempts to observe, through immunohistochemistry, whether there is expression in SACC, and further explore the relation between Survivin and the occurrence, development and prognosis of SACC.Methods:This experiment involves two parts.Randomly draw 38 paraffin wax specimens of SACC with follow-up data (1988-2004),by Southwest Hospital and Dental Hospital Attached to Chiongqing Medical University. The expression of Survivin and apoptosis in SACC is detected through immunohistochemistry and TUNEL, and analysis is made on the basis of clinical pathology and follow-up data to explore the significance of the expression of Survivin.Know about the morphological features of ACC-2 and ACC-M by cultivating their cell strains, detect the expression of Surivin in ACC-2 and ACC-M through immunocytochemistry (SP), and explore the relation between the expression intensity of Survivin in SACC and the metastasis of SACC.Results:1. Expression of Survivin in SACC The expression of Survivin in SACC is located in cytoplasm,in the shape of Buffy particle, which is absent in normal salivary gland tissues. Among the 38 paraffin wax specimens of SACC , there are 26 specimens with positive expression of Survivin, with the positive rate being 68.4% (26/38).2. Correlation between Survivin expression and linicopathological featureCorrelation analysis and research reveal that surviving expression was independent of patient's age, sex, site, pathological type, tumor size, clinical stage and metastasis of lymphonodi cervicales ( P > 0. 05)3. Correlation between Survivin expression and apoptotic indexSurvivin expression in SACC is correlated with apoptotic index. Survivin expression was strongly associated with the apoptotic index (0.61%±0.19% versus 3.24%±0.38%; P<0.001)4. Correlation between Survivin expression and prognosisSurvivin expression in SACC is directly related to patient's prognosis. The 5-year survival rate of patients with Survivin-positive tumors is 38.5% (10/26), while the 5-year survival rate of patients with Survivin-negative is 83.3% (10/12), with a significant difference (P < 0.05).5. Morphological observationUnder the inverted phase contrast microscope, ACC-2 and ACC-M grow adherently, characterized by polygonal epithelioid cell Karyomegaly, round and a few clear nucleoli. Particles of different lucency can be observed in intracytoplasm,and cell division appears frequently with multipolar division. The particles, when arranging closely, look like rubbles used to pave the road, and when densely populated, may overlap, with the disappearance of contact inhibition.HE-stained, cell nuclei lie off position under light microscope, with the outer endochylema in deeper color and olistherozone in endochylema. Cell nuclei are in light purple and cell division appears frequently with multinucleated giant cell.6. Growth curve of cellsThe next day after the inoculation of ACC-2 and ACC-M, the OD value, which represents the number of cells, begins to rise, cells come into exponential phase of growth, and the growth curve of cells takes the shape of"S".7. Survivin expression in ACC-2 and ACC-MThe immuocytochemistry research reveals that Buffy particles in cytoplasmic domain of ACC-M take deeper color than ACC-2; that gray scale values are 168.55±10.96 and 126.00±13.06( P < 0. 05); and that Survivin expression in ACC-M is much stronger than ACC-2 cells.Conclusions:Survivin expression is obvious in SACC tissues and absent in normal salivary gland tissues. Survivin expression in SACC is independent of patient's age, sex, site, pathological type, tumor size, clinical stage and metastasis of lymphonodi cervicales, but correlated with apoptosis and prognosis of tumor cells. The extent of Survivin expression in SACC cells is highly correlated with the occurrence of pulmonary metastasis; therefore, the detection of Survivin in SACC tissues can be used as a subsidiary judgment index of prognosis of SACC.