The Expression And Significance Of Survivin In Prostate Cancer With Neuroendocrine Differentiation

Objective To investigate the expression and significance of survivin in prostate cancer with neuroendocrine differentiation,to analyze the relativity of the expression of survivin and prostate cancer with neuroendocrine differentiation,the correlation of it and the clinical stage and histological grading,and the prospect of it in the treatment to androgen-independent prostate cancer.Methods The medical records including histopathological features of patients with prostate cancer and begnign prostatic hyperplasia diagnosed between Jan 2003 and Nov 2007 were retrieved from the Third Xiangya Hospital of Central South Univerity.Tumor Slides stained with hematoxylin and eosin(H&E)from these patients were reviewed.To observe the expression of three protein in the same tissue,the serial tissue slides were used and different proteins were observerd in the same tissue and the same position.The degree of-neuroendocrine differentiation in prostate cancer depended detection of secreta of neuroendocrine cells. Immunohistochemistry staining of streptavidin/peroxidase were performed using antibodies to chromogranin A(CgA)and synaptophysin (SYN)for elevating the detection rate of neuroendocrine differentiation. NED are defined as cytoplasm of prostate cancer cells that express chromogranin A(CgA)and/or synaptophysin(SYN).At the same time, survivin was detected immunohistochemically in the same way.The expression of survivin was observed in prostate cancer with neuroendocrine differentiation.Results(1)The positive rates of SYN,CGA and survivin in 28 cases PCa were respectively 53.6%,50.0%,89.3%,while the positive rate of survivin was 11.1%and negative of SYN and CgA in 9 cases BPH. There were obvious diffrences for the three proteins respectively in the between prostate cancer and begnign prostatic hyperplasia.(p＜0.05). (2)There were 25 cases(89.3%)positive expression of survivin and 21cases positive expression of SYN and/or CgA in 28 cases prostate cancer.The positive expression of survivin was 20(95.2%)in the 21cases prostate cancer with positive expression of SYN and/or CgA,and survivin expression had positive correlation to NED in the PCa.(correlation coefficient,r_s＞0)(3)There were 14(50%)positive expression of CgA,15(53.6%).positive expression of SYN and 8 of them were positive for both SYN and CgA in the 28 cases prostate cancer, while 21(75%)were positive for SYN and/or CgA.It was obvious for that improved the detection rate of NED in the way of examining SYN and CgA at the same time.(4)The expressioh of survivin had no significant relationship with age,for there was no obvious difference by comparing the＞70 years old patients with＜70 ones(p＞0.05).But it was significantly related to clinical stage and histological grading of PCa,for there were different obviously by comparing low and moderate histological grading prostate cancer group with high one and comparing A-B stage prostate cancer group and C-D stage one.(p＜0.05)Conclusion(1)The combined assay of SYN and CgA in prostate cancer tissue could raise the detection rate of prostate cancer with neuroendocrine differentiation.(2)The expression of survivin had significant relationship with clinical stage and histological grading of PCa.It increased with escalation of clinical stage and histological grading of PCa.(3)The expression of Survivin had positively related with the degree of neuroendocrine differentiation.The escalation of expression of survivin might result in neuroendocrine differentiation in the prostate cancer for survivin could inhibit apoptosis of neuroendocrine differentiation cells.Neuroendocrine differentiation cells could produce stimuli for proliferation of the surrouding carcinoma cells and inevitablely make prostate cancer become androgen-independent,and no longer responsive to hormonal manipulation...