| Ovarian cancer is a common gynecologic carcinoma. There isn't effective early diagnosis and treatment for it. The death due to ovarian cancer takes the first place in various types of gynecological tumors. Most of malignancy is epithelial cancer, about to 60%-90%. Apoptosis and proliferation imbalance are the bases of leading to tumor development and progression. The related factors change of apoptosis and proliferation expression are the hot spot of ovarian cancer research.Livin is a newly discovered inhibitor of apoptosis protein IAP family members, through the BIR region and caspase-3,7,9 binding to inhibit its activity, thereby inhibiting apoptosis. Smac/DIABLO (second mitochondria -derived activator of caspase/direct IAP-binding protein with low PI) which was discovered in 2000 as a present in the mitochondria is a protein used to regulate apoptosis. Its role is to remove the inhibitory effect of IAPs on Caspase and to advance apoptotic. The antagonism between Livin and smac is an important link to transfer tumor cell apoptotic signal in the network.As a cell proliferation marker postural antigen, Ki-67 function is closely related with mitosis. It had been initially used to study the biological behavior and to judge the dangers of cancer, which is considered to reflect the ideal target cell proliferation in recent years.This study investigated the expression of the three facter change and the relationship with the happen & development of cancer and clinicopathologic factors, is to supply the preraration for ovarian cancer diagnosis and treatment research.ObjectiveIn the study, immunohistochemical SP mothed is used to observe the expression and difference of inhibitor of apoptosis protein Livin, apoptosis-related factors Smac and prolife rating cell nuclear antigen Ki-67 in epithelial ovarian cancer, borderline ovarian tumors, benign ovarian tumors and normal ovarian tissues, then analyze the relevance of the three.Materials and methods1 Materials:110 ovarium specimens were obtained from the Third Affiliated Houspital of Zhengzhou Universtiy patients from October 2008 to March 2010. Study is divided into 4 groups. The first group had 50 epithelial ovarian cancers. The second group had 20 borderline ovarian tumors. The third group had 20 benign ovarian tumors. The last group had 20 normal ovarian tissues. According to histological classification,50 ovarian cancers are divided into 20 serous carcinoma,12 mucinous carcinoma,10 endometrial carcinomas and 8 clear cell carcinoma. No patient had received preoperative chemotherapy, radiation therapy and immunosuppressive therapy. Exclusion of the age, weight, geographical differences and menstrual cycle, and other interference factors, the specimens were confirmed by two or more pathology physicians.2 Methods:In the study, immunohistochemical SP mothed is used to observe the expression of inhibitor of apoptosis protein Livin, apoptosis-related factors Smac and proliferating cell nuclear antigen Ki-67 in epithelial ovarian cancer, borderline ovarian tumors, benign ovarian tumors and normal ovarian tissues. According to staining intensity and positive cell percentage of total cell number, it is determined by double points score semi-quantitative. Using the double-blind,2 person independent do the film-reading and check the results, then get a consensus.3. Statistical Methods:Statistical software SPSS 17.0 is used toχ2 test and correlation analysis. a=0.05 difference had statistical significance. Result1 The expression of LivinLivin protein was mainly expressed in the cytoplasm, and occasionally can be expressed in the nucleus. Positive cells were filamentous brown under the microscope.1.1 The expression of Livin in different ovarian oganiztionThe positive expression rates of Livin protein in epithelial ovarian cancer, borderline ovarian tumors, benign ovarian tumors and normal ovarian tissues were: 52%,25%,10%,0%. Studying the expression differences in four different ovarian tissues had statistics significance (χ2=24.143, P<0.05).1.2 The expression of Livin in different histologyHistological can be divided into three grades:G1, G2,G3in epithelial ovarian cancer. There are 18 G1 grade,15 G2 grade and 17 G3 grade. The positive expression rates were:27.8%,53.3%,76.5%. Groups differences have statistical significance (P <0.05).1.3 The expression of Livin in the lymph node metastasis groupThe positive rates of lymph node metastasis group immunohistochemical staining were 65.4% and 37.5% without metastasis in the lymph node metastasis group. Groups differences have statistical significant (P<0.05).1.4 The expression of Livin in different clinical stage10 patients with clinical stage I,13patients with clinical stageⅡ,14 patients with clinical stage III and 13 patients with clinical stage IV in the 50 ovarian cancer. The expression of Livin were 47.8% and 55.6% in the clinical phadeⅠ～,andⅢ-IV. The expression difference had no statistics significance (P> 0.05).1.5 The expression of Livin in different histological classificationThe expressions of Livin were:60%,41.7%,50% and 50% in serous carcinoma, mucinous carcinoma, endometrioid carcinoma and clear cell carcinoma. There is no statistics significance among histological classification groups (P> 0.05). 2 The expression of SmacSmac protein was mainly in the cytoplasm and membrane color, brownish yellow granules.2.1 The expression of Smac in different ovarian oganiztionThe positive expression rates of Smac protein in epithelial ovarian cancer, borderline ovarian tumors, benign ovarian tumors and normal ovarian tissues were: 66%,80%,90%,100%. Studying the expression differences in four different ovarian tissues had statistics significance (χ2=15.682, P<0.05)2.2 The expression of Smac in different histologyHistological can be divided into three grades:G1, G2, G3 in epithelial ovarian cancer. The positive expression rates were:88.9%,66.7%,41.2%. Groups differences have statistical significant (P<0.05).2.3 The expression of Smac in the lymph node metastasis groupThe positive rates of lymph node metastasis group immunohistochemical staining were 50%and 83.3% without metastasis in the lymph node metastasis group. Groups differences have statistical significant (P<0.05).2.4 The expression of Smac in different clinical stageThe expression of Smac protein were 69.6% and 63.3% in the clinical phadeⅠ～ⅡandⅢ～Ⅳ. The expression difference had no statistics significance (P>0.05).2.5 The expression of Smac in different histological classificationThe expression of Smac protein were:65%,66.7%,70%,62.5% in serous carcinoma, mucinous carcinoma, endometrioid carcinoma and clear cell carcinoma. There is no statistics significance among histological classification groups (P>0.05).3 The expression of Ki-67Ki-67 protein was mainly in the cytoplasm and nuclear color, brownish yellow granules.3.1 The expression of Ki-67 in different ovarian oganiztionThe positive expression rates of Livin protein in epithelial ovarian cancer, borderline ovarian tumors, benign ovarian tumors and normal ovarian tissues were: 72%,45%,30%,0%. Studying the expression differences in four different ovarian tissues had statistics significance (χ2=32.671, P<0.05)3.2 The expression of Ki-67 in different histologyHistological can be divided into three grades:G1, G2, G3 in epithelial ovarian cancer. The positive expression rates were:50%,73.3%,94.1%. Groups differences have statistical significant (P<0.05).3.3 The expression of Ki-67 in the lymph node metastasis groupThe positive rates of lymph node metastasis group immunohistochemical staining are 84.6% and 58.3% without metastasis in the lymph node metastasis group. Groups differences have statistical significant (P<0.05).3.4 The expression of Ki-67 in different clinical stageThe expression of Ki-67 protein were 69.6% and 74.1% in the clinical phadeⅠ-ⅡandⅢ～Ⅳ. The expression difference had no statistics significance (P>0.05).3.5 The expression of Ki-67 in different histological classificationThe expression of Ki-67 protein were:70%,75%,70%,75%in serous carcinoma, mucinous carcinoma, endometrioid carcinoma and clear cell carcinoma. There is no statistics significance among histological classification groups (P>0.05).4 The relevance of Livin,Smac and Ki-67Livin and Smac expression were negatively correlated (r=-0.332,P<0.05), Livin expression and Ki-67 were positively correlated (r=0.357, P<0.05), Smac and Ki-67 expression were negatively correlated (r=-0.293, P<0.05) in ovarian cancer.Conclusion1 Livin and Ki-67 are related with occurring and development of ovarian. The increase and decrease of both have certain tip role of malignancy.2 Three of Smac, Livin and Ki-67 have some relevance. Monitoring the expression of Livin, Smac and Ki-67 in the ovarian carcinoma, it can help to diagnose forepart ovarian carcinoma. Livin, Smac, and Ki-67 is expected to become a new point for treatment of ovarian cancer. |
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