| Objective：Squemous Cell Carcinoma(SCC) is about 80%～85% of cervical cancer.Based on the global cancer statistics: about 529.8 thousand new cervicalcancer cases and 275.1 thousand cancer deaths are estimated to have occurredin 2008, more than 85% of these cases and deaths occur in developingcountries. It is harmful for female heath,which is one of the main malignanttumors. With molecular biology development, plenty of researches indicatedthat cell apoptosis is play an important part in many carcinomas. The cellproliferation、differentiation and apoptosis have keeping dynamic balance inorganism, which maintain body steady-state. Therefore cell apoptosis plays animportant role in the pathogenesis of cancer. Abnomal expression of cellapoptosis pathway any gene, it result in occurring and developing of varitiescarcinomas, moreover, it plays an important factor influence on cancercurative effects. So far, inhibitor of apoptosis proteins have discovered eightmembers: CIAP1(HIAP1)、CIAP2(HIAP2)、NIAP、XIAP(ILP1)、ILP2、Survivin、Bruce(Apollon) and Livin(ML-IAP/ KIAP). The aim of this study isto observe the expression and correlation of the apoptosis related geneSurvivin and Livin by immunohistochemistry(S-P method) and TUNEL[terminal deoxynucleotidyl transferase (TdT) mediated dUTP nick end label-ing] before and during the treatment, and analyze the association to the clinical features of SCC between the two genes and apoptosis, explore radio-therapy(RT) and concurrent chemoradiotherapy(CCRT) lead to change statusof apoptosis, explore the correlation of the Survivin and Livin, analyzed thecell cycle distribution by flow cytometry(FCM), expect through synchroniz-ing cell cycle to explicate mechanism of cell apoptosis, further supportCCRT as standard model therapy of advanced SCC.Methods：Forty-eight patients were divided into two groups: radiotherapy(RT)group and concurrent chemotradioherapy(CCRT) group, the specimens of thecervical tumors were obtained by biopsy before and during theradiotherapy (10Gy irradiation), to investigate the expression of Survivin、Livin of advanced SCC and analyze correlations to the clinical features. Theapoptosis expression were detected by TUNEL method and counted outapoptosis index (AI), analyzed the association between the two genes andapoptosis. The cell cycle distribution was analyzed by FCM. SPSS 13.0software was employed to analyze all data, the qualitative data were analyzedbyχ2 test or Fisher,s exact test, the quantitative data were examined byindependent samples t test or paired samples t test. The relationship of the twofactors was examined by the Spearman rand correlation test, within whichp<0.05 set for statistically differences.Results：1. The expression of Survivin、Livin and AI of advanced SCC, whichanalyzed correlations to their clinical features.The positive expression rates of Survivin、Livin and AI were 66.67%（32/48）、70.83%(34/48)、29.17%(14/48), which have no relationship withthe age、pregnancy frequency、diameter of tumors、general types of tumors、 clinical stages、histological grade(p>0.05).2. The expression of Survivin、Livin before and during the therapy(10Gy irradiation and /or chemotherapy)Initiating RT, the positive expression rates of Survivin、Livin were65.22% (15/ 23)、73.91%(17/23) respectively, two genes expressionwere 68.00%(17/25)、68.00%(17/25) in CCRT group, there was nosignificant difference between the two groups(p>0.05).10Gy irradiation RT groups, the positive expression rates of Survivin、Livin were 56.52%(13/23)、65.22%(15/23) respectively, two genes expres-sion were 44.00% (11/25)、40.00%(10/25) in CCRT group, there was nosignificant difference between the two groups all the same (p>0.05).Before and during the therapy, The positive expression rates Survivinwere decreased both group, but there was no significant differencebetween them (p>0.05).Before and during the therapy, The positive expression rates Livin weredecreased both group, but the CCRT group significantly decreased the ratesthan RT group, the differences have statistical significance(p=0.044)3. The expression of AI before and during the therapy (10Gy irradiationand /or chemotherapy)Before therapy, apoptosis index were (12.72±9.96)%、(10.55±6.70)%respectively,there was no significant difference betweengroups(p=0.375).After therapy, apoptosis index were (26.99±20.21)%、(30.92±22.31 )%,there was no significant difference between groups(p=0.526). But the AIwere significantly increased after initiating RT and CCRT(p<0.05). 4. The correlations between Survivin、Livin and AI before therapyBased on expression of Survivin、Livin, calculate the AI respectively, Ifound there were no correlations between three factors(p>0.05).5. The correlations between Survivin、Livin and AI after therapyWhether expression of Survivin or not, calculate the AI:(28.29±20.95) %, (29.80±21.87)% respectively. there was no significantdifference between two groups(p=0.809). Whether expression of Survivinor not, calculate the AI:(24.60±20.71)%, (33.88±21.11)% respectively,there was no signifi -cant difference between them (p=0.131). There wereno correlations between Survivin and AI (rs= -0.075，p=0.309), betweenSurvivin and Livin (rs=0.125，p=0.198), but Livin and AI were significant lynegative correlated (rs=-0.274，p=0.030).6. Before therapy, the cell cycle was no difference obviously. We foundthe cervical cancer cells were arrested in G2/M and S phase during treatment.However, CCRT group saw a typical hypodiploid peak, the cell cycles havesynchronized tendency.7. All patient reexamine comprehensively after three months,preoperative radiotherapy who have two persons is stable disease, one ispartial response , lymph node without malignant cells simultaneously. Radicalradiotherapy who have three progressive disease, there was no significantdifference between them(p>0.05). The total effective rate of RT group is82.61% (19/23), another group is 96.00%(24/25), there was nosignificant difference between the two groups(p>0.05).Conclusions：1. The expression of Survivin、Livin and AI of advanced SCC have no relationship with the age、pregnancy frequency、diameter of tumors、generaltypes of tumors、clinical stages、histological grade(p>0.05).2. Before and during the therapy, The positive expression rates Survivinwere decreased both group, but there was no significant differencebetween them(p>0.05).The positive expression rates Livin were decreasedboth group, but the CCRT group significantly decreased the rates than RTgroup, the differences have statistical significance(p=0.044).The AI weresignificantly increased after initiating RT and CCRT. But there was nosignificant difference between groups(p<0.05).3. Based on expression of Survivin、Livin, calculate the AI respectively,I found there were no correlations between three factors(p>0.05). Aftertherapy, there were no correlations between Survivin and AI or Livin , butLivin and AI were significantly negative correlated(p<0.05).4. Before therapy, the cell cycle was no difference obviously. We foundthe cervical cancer cells were arrested in G2/M and S phase during treatment.However, CCRT group saw a typical hypodiploid peak, the cell cycles havesynchronized tendency.5. During radiation, chemotherapy without produce an important effecton recent period effectiveness. |
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