The Research On Expression And Associativity Of Smac Protein And Survivin Protein In Bladder Transitional Cell Carcinoma

Objiective: Bladder transitional cell carcinoma(BTTC)is the most common tumor in urinary system. Its incidence rate increased in recent years.they are characterized by high recurrence rate after operation. In some recurring cases, there is a kind of aggravating tendency in the tumor biological characteristic, such as infiltration and metastasis. The apoptosis of tumor cells play an important role in the development of tumor. Smac protein (the second mitochodria -derived activator of caspase) is a proapoptosis potien released from mitochondrion, which induces cell apoptosis by relieving the inhibition of IAP (inhibitor of apoptosis proteins). Smac protein is the fist mammalian protien that can inhibit IAP by direct binding. Survivin protien is a member of IAP, Which is the most powerful inhibitor of apoptosis. Survivin is expressed in many tumors and its high expression assiocates with poor prognosis. In our research it is fist time to detect the expression and associativity of Smac Proteinum and Survivin Proteinum in BTCC by FCM.Methods: All samples were from patients in the Fouth Affiliated Hospital of Hebei Medical University from 2007.6 -2007.12. There were 44 samples of BTCC. 31 from men and 13 from women. Their age was from 32 to 77, averaging 58.1. there were 44 samples of the peritumorial tissue 2 cm away from the tumor . All the tumorous samples were confirmed to be from BTCC by pathological diagnosis. 10 samples of bladder normal mucosa (obtained from non malignant tissue) were used as control. The samples in control group were confirmed to be from normal mucosa by pathological diagnosis. Histologic grade (WHO): G₁ 12 cases, G₂23cases, G₃ 9 cases. According to clinical stage (UICC-TNM): T₁ 13 cases, T₂ 26 cases, T₃ 5 cases. The samples were detected by FCM. The quantify of protein were expressed by FI (fluorescence index). The quantify of protein with FI more then 1.0 are considered positive, otherwise negative. All data were tested by SPSS13.0 software, P<0.05 was considered statistical significance.Results: 1. The positive expression rate of Smac protien in BTCC was 18.1%(8/44), The positive expression rate in adjacent normal tissue was 68.1%(30/44), The positive expression rate in bladder normal mucosa was 75.0%(9/12). The positive expression rate of Smac protien in BT_CC was lower than in peritumorial tissue. The difference was statistical significance .(P<0.01). The positive expression rate of Smac protien in BTCC was lower than in the bladder normal mucosa. The difference was statistical significance .(P<0.01)there is no statistical significance between in the bladder normal mucosa and peritumorial tissue. (P>0.05). 2. The positive expression rate of Survivin protien in BTCC was 77.2 % (34/44), The positive expression rate of peritumorial tissue was 20.1% (9/44), The positive expression rate of bladder normal mucosa was 16.7%(2/12). The positive expression rate of Survivin protien in BTCC was higher than in peritumorial tissue. The difference was statistical significant (.P<0.01). The positive expression rate of Survivin protien in BTCC was higher than in the bladder normal mucosa. The difference was statistical significance . ( P<0.01 ) There is no statistical significance between in the bladder normal mucosa and peritumorial tissue. (P>0.05). 3. The positive expression rate of Smac protien in BTCC G₁ grade is 41.7%(5/12), G₂ 13.0%(3/23), G₃ 0%(0/9). There was statistical significance in three groups. (P<0.05). There was no statistical significance in G₁ and G₂, also in G₂ and G₃. There was statistical significant between in G₁ and G₃, (P<0.05), The positive expression rate of Smac protien in BTCC in G₃ was lower than in G₁. 4. The positive expression rate of Survivin protien in BTCC G₁ grade was 58.3%(7/12), G₂ 78.2%(18/23), G₃ 100%(9/9). There was statistical significance in three groups. (P<0.05) 5. There was no statistical significance in G₁ and G₂, also in G₂ and G₃. There was statistical significance in G₁ and G₃, (P<0.05), The positive expression rate of Survivin protien in BTCC in G₃ was higher than in G₁. 5. The expression of Smac and Survivin have no relationship with age, gender, clinical Stage. 6. The expression of smac and survivin in BTCC is negative correlation, r=- 0.588, (P<0.01)Conclusions: 1. The positive expression rate of Smac protien in BTCC is lower than that in peritumorial tissue and the bladder normal mucosa, The positive expression rate of Survivin protien in BTCC is higher than that in peritumorial tissue and the bladder normal mucosa. The results indicate that low expression of smac and high expression of survivin promote the genesis and development of BTCC. 2. The expression of Smac and Survivin have different tendency, the expression of Smac is high while the expression of Survivin is low. They can be detected together to be an indicator to judge malignant degree of the tumor. 3. The expression of Smac and Survivin have no relationship with age, gender, clinical Stage. 4. The expression of smac is negative correlated with the expression of survivin in BTCC. It suggest that smac and survivin play an important roles in cancer cell apoptosis. The relationship between smac and survivin may play an important role in BTCC. Adjusting smac and survivin protein level may become a new method to cure BTCC.