Expression And Significance Of Livin And Smac In Endometrial Carcinoma

ObjectiveEndometrial carcinoma is now the most common pelvic genital cancer in women.. Endometrial carcinoma threaten women healthy acutely,and its mechanism is rather complex.Modern molecular biology studies have shown that the formation and development of malignant tumors are not only associated with abnormal proliferation and differentiation,but also involved in inhibition of apoptosis,which was one of the important mechanisms in the forming of tumors.The inhibitor of apoptosis protein(IAP) family consists of a group of structurally related protein swith antiapoptotic properties.A novel member of this family is the Livin protein.It has been shown that the expression of Livin can block apoptosis induction by a variety of proapoptotic stimuli by inhibiting caspases-3,-7and-9.The Livin gene exhibits are stricted expression pattem,since it has been found to be expressed in certain tumor cells,including melanoma or HeLa cervieal carcinoma cells,but not in most normal adult tissues. Smac,discharged to cytoplasm by mitochondria,is an important apoptosis regulatory factor.It may combine with all the IAPs that have been discovered and cause them to lose their activity to inhibit caspase.At the same time,Livin,as E3 ubiquitin ligases,may dissolve Smac.This study,by means of immunohistochemical staining method,aims to test the expression of Livin and Smac in endometrial adenocarcinoma,simple endometrial hyperplasia,endometrial atypical hyperplasia,and normal endometrium,and to explore their functions and corelation in the occurrence and development of endometrial carcinoma.Methods1.PatientsIn this study,the samples were chosen from benign and malignant endometrium 91 cases who suffered from hysterectomy at the Department of Gynecology and Obstetries,Shengjing Hospital of China Medieal University,from 2003-1 to 2008-6. They had been diagnosised correctly by routine pathological examination.None of the patients had received radiotherapy,chemotherapy,hormonal therapy and other treatrnent before operation.The range of year from 36Y to 73Y.These 91 cases of specimens included endometrial adencarcinoma,endometrial atypical hyperplasia and normal endometrium.2.MethodsThe expressions of Livin and Smac protein in tissues from 45 cases of Endometrial adenocarcinoma,28 endometrial atypical hyperplasia,and 18 normal endometrium were detected by using irnnnunohistochemistry S-P method and image analysis system.3.Statistical AnalysisSPSS13.0 soft ware was employed to analyze all data.Statistical evaluation was performed using x~2 test and Spearman test.P<0.05 was considered as statistical significance.Results1.In the irnnnunohistochemistry stain,Livin protein maily restricted to eytoplasm. Being compared with normal endometrium,the expression of Livin protein in the cases of atypceal hyperplasia and careinoma was significantly up-regulation(x ~2=28.714,P<0.01).There was significantly difference between different pathological grade(P<0.05)and muscular invasion depth(P<0.01),the expression of Livin has no significant difference with clinical stage and lymph node metastase(P＞0.05).2.In the irnnnunohistochemistry stain,Smac protein also maily restricted to eytoplasm.Being compared with normal endometrium,the expression of Smac protein in the cases of atypceal hyperplasia and careinoma was significantly down-regulation(x~2=7.533,P<0.05).There was significantly difference between different pathological grade(P<0.01),clinical stage(P＜0.05)and lymph node metastase(P<0.05),the expression of Smac has no significant difference with muscular invasion depth(P＞0.05). 3.Negative correlations were observed between the expression of Livin and Smac protein(r=-0.43,P＜0.01).Conclusions1.The high expression of Livin protein in carcinoma was closely related to pathological grade and muscular invasion depth,and it could be tumor marker and evaluating prognosis in endometrial carecinoma.2.The low expression of Smac protein in careinoma was closely related to pathological grade,clinical stage and lymph node metastase,and it could be a important role in the development of endometrial carecinoma.3.The expression of Livin and Smac protein in endometrial carecinoma were negative correlated.