The Expression And Clinical Significance Of Survivin, Smac And Bax In Breast Invasive Ductal Carcinoma

Objective:Breast carcinoma is one of the most common malignant tumors of female in the world. In last few years the incidence of breast carcinoma has an increased trend, and the age of onset is becoming younger and younger, which has greatly threatened female life and health. Recently, many studies have shown that the occurrence and development of breast carcinoma may have significant relationship with the abnormal apoptosis. The apoptosis not only affects the occurrence and development of breast carcinoma, and inducing apoptosis is the main treatment of radiotherapy and chemotherapy and biotherapy in tumor therapy. With the continuous development of molecular biology, it has been the attention of people that discussing the occurrence and development of breast carcinoma from the angle of apoptosis. Survivin, Smac and Bax may be involved in the apoptosis of cancer cells through different mechanisms. In this study, we try to use immunohistochemical method to detect the expression of Survivin, Smac and Bax and analyse the relationship between them and clinicopathological features of breast in order to look for a new and effective detection of breast carcinoma, and provide theoretical foundation for the auxiliary diagnosis, guiding treatment and judging prognosis of breast carcinoma.Methods:We randomly selected the 88 cases of specimen of patients with breast carcinoma (invasive ductal carcinoma) and 32 cases of distal normal tissue from carcinoma (>10cm). All patients for the first time found the tumor, and have not been in radiotherapy, chemotherapy and endocrine therapy before the operation.The S-P immunohistochemical method was used to examine the expression of Survivin, Smac and Bax in 88 cases breast carcinoma tissues and 32 cases of distal normal tissues from carcinoma. The correlations between the expression and the clinicopathological features (such as age, tumor size, pathological grade, clinical stage, lymph node metastasis) of the carcinoma were analyzed. And the correlations between Survivin, Smac and Bax were analyzed. Data analysis is via SPSS 17.0, and P< 0.05 for the difference was statistically significance.Results:1 Expression of Survivin, Smac and Bax protein in breast invasive ductal carcinoma tissuesThe positive expression rate of Survivin in 88 cases of breast invasive ductal carcinoma tissues was 71.59%, which was higher than that in 32 cases of distal normal tissues from carcinoma (P<0.05). The positive expression rate of Smac in 88 cases of breast invasive ductal carcinoma tissues was 55.68%, that of Bax was 79.07%, and the expression in tissues of breast invasive ductal carcinoma were lower than that in the distal normal tissues (P<0.05).2 The correlationship between Survivin, Smac and Bax protein expression with clinic pathological parametersThe expression of Survivin was closely correlated with the pathological grade of breast invasive ductal carcinoma, and the positive expression rate in Ⅰ～Ⅱ level group (62.71%) was lower than that in Ⅲ level group (89.66%, P<0.05). And the expression of Survivin was closely correlated with the clinical stage of breast invasive ductal carcinoma, the positive expression rate in Ⅰ～Ⅱ period group (61.54%) was lower than that in Ⅲ～Ⅳ period group (86.11%, P<0.05). Besides, the expression of Survivin is closely correlated with lymph node metastasis, the positive expression rate in group with lymph node metastasis (80.36%) was higher than that in group without lymph node metastasis (56.25%),P<0.05). However, there were no significantly correlated between expression of Survivin with age, sex and size of tumors.The expression of Smac was closely correlated with the pathological grade of breast invasive ductal carcinoma, and the positive expression rate in Ⅰ～Ⅱ level group (64.41%) was higher than that in Ⅲ level group (37.93%, P<0.05). In addition, the expression of Survivin was closely correlated with the clinical stage of breast invasive ductal carcinoma, and the positive expression rate in Ⅰ～Ⅱ period group (65.38%) was higher than that in Ⅲ～Ⅳ period group (41.67%, P<0.05). Besides, the expression of Survivin is closely correlated with lymph node metastasis, the positive expression rate in group with lymph node metastasis (46.43%) was lower than that in group without lymph node metastasis (71.88%, P<0.05). However, there were no significantly correlated between expression of Survivin with age, sex and size of tumors.The expression of Bax is closely correlated with lymph node metastasis, and the positive expression rate in group with lymph node metastasis (51.79%) was lower than that in group without lymph node metastasis (84.38%, P<0.05).3 The correlationship between the expression of survivin protein and Smac, Bax in breast invasive ductal carcinomaThe expression of Survivin was significanly positive correlated with the expression of Smac in tissues of breast invasive ductal carcinoma (r=-0.410, P<0.05). However, no correlation is found between the expression of Survivin and Smac(r=-0.162), there was no significant difference (P>0.05).Conclusions:1 Survivin was overexpressed in tissues of breast invasive ductal carcinoma. Smac and Bax were lowly expressed in breast invasive ductal carcinoma tissues, which was associated with the occurrence of breast invasive ductal carcinoma.2 The expression of Survivin in breast invasive ductal carcinoma tissues had no relations with age and tumor size (P>0.05). But the expressiom of Survivin related to pathological grade, clinical stage and lymph node metastasis:the positive expression rate in Ⅰ～Ⅱ level group was lower than that in Ⅲ level group (P<0.05); and the positive expression rate in Ⅰ～Ⅱ period group was lower than that in Ⅲ～Ⅳ period group (P<0.05); Besides, the positive expression rate in group with lymph node metastasis was higher than that in group without lymph node metastasis (P<0.05), which indicates that the abnormal expression of Survivin was correlated with the development of breast invasive ductal carcinoma.3 The expression of Smac in breast invasive ductal carcinoma tissues had no relations with age and tumor size (P>0.05). But that of Smac related to pathological grade, clinical stage and lymph node metastasis:the positive expression rate in Ⅰ～Ⅱ level group was higher than that in Ⅲ level group (P<0.05); And the positive expression rate in Ⅰ～Ⅱ period group was higher than that in Ⅲ～Ⅳ period group (P<0.05); Besides, the positive expression rate in group with lymph node metastasis was lower than that in group without lymph node metastasis (P<0.05).4 The expression of Bax in breast invasive ductal carcinoma tissues had no relations with age, tumor size pathological grade and clinical stage (P>0.05). But that of Bax related to lymph node metastasis, the positive expression rate in group with lymph node metastasiswas lower than that in group without lymph node metastasis (P<0.05), which showed that downregulation of Bax induced the infiltration and metastasis of breast carcinoma.5 There was negatively correlated with the expression of Survivin and Smac in tissues of breast invasive ductal carcinoma (P<0.05), which indicated that negative feedback or antagonistic to each other of Survivin and Smac was existed.No correlation was found between the expression of Survivin and Bax (P>0.05).