焦建新++++++温风霞++++++张玲玲++++++焦东晟++++++李蕾++++++季万胜++++++冯玉光++++++张小茜

[摘要] 目的 探讨胃癌组织中Survivin的表达与临床病理因素及其与幽门螺杆菌（H.pylori）感染之间的关系。 方法 采用免疫组织化学方法检测60例胃癌组织中Survivin的表达情况；采用快速尿素酶法及Warthin-Starry银染色法检测60例胃癌组织中的H.pylori感染情况。分析Survivin表达与各临床病理因素及H.pylori感染的关系。所有患者随访至少5年或直到死亡。 结果 60例胃癌组织中Survivin表达阳性率为68.3%，肿瘤侵及固有肌层组（77.8%）和浆膜层组（60.0%）Survivin的表达高于肿瘤局限于黏膜及黏膜下层组（44.4%），差异有统计学意义（P<0.05）；低分化组Survivin的表达高于中高分化组（81.8%比55.6%，P<0.05）；Survivin阳性表达率在有淋巴结转移的胃癌组织中明显高于无淋巴结转移的胃癌组织（80.4%比44.4%，P<0.05）；TNM分期Ⅲ/Ⅳ期胃癌组织Survivin表达的阳性率明显高于Ⅰ/Ⅱ期（86.5%比56.5%，P<0.01）；Survivin表达阳性患者5年生存率明显低于表达阴性患者（39.0%比63.2%，P<0.05）；Survivin阳性表达率在H.pylori阳性胃癌组织中明显高于H.pylori阴性胃癌组织（75.6%比46.7%，P<0.05）。 结论 Survivin的表达与胃癌的发生、发展有关，可作为判断胃癌预后的一个客观指标；H.pylori感染能够促进Survivin的表达。

[关键词] 胃肿瘤；Survivin；幽门螺杆菌；免疫组织化学

[中图分类号] R735.2 [文献标识码] A [文章编号] 1674-4721（2016）02（a）-0004-05

Relationship between Survivin expression and Helicobacter pylori infection in gastric cancer

JIAO Jian-xin1 WEN Feng-xia1 ZHANG Ling-ling2▲ JIAO Dong-sheng1 LI Lei1 JI Wan-sheng1 FENG Yu-guang1 ZHANG Xiao-qian1

1.Department of Gastroenterology，the Affiliated Hospital of Weifang Medical University，Shandong Province，Weifang 261031，China；2.Department of Oncology，Binzhou People′s Hospital，Shandong Province，Binzhou 256610，China

[Abstract] Objective To explore the relationship between Survivin expression and the clinicopathologic parameters of Helicobacter pylori （H.pylori） infection in gastric cancer. Methods In 60 patients with gastric cancer，expression of Survivin was detected by immunohistochemistry，H.pylori infection was determined by Warthin-Starry staining and rapid urease test.All the cases were followed up at least 5 years or until death.The relationship between Survivin expression and the clinicopathologic parameters，H.pylori infection was respectively analyzed. Results The positive rate of Survivin was 68.3% （41/60） in 60 patients with gastric cancer.The positive rate of Survivin in cases limited to muscularis and serosa was higher than that of Survivin in cases limited to mucosa and submucosa （77.8%，60.0%，44.4%，P<0.05）.Survivin expression rate was higher in poorly differentiated group than that in well differentiated one （81.8% vs 55.6%，P<0.05）.The positive rate of gastric cancer with lymph node metastasis was higher than that of gastric cancer without lymph node metastasis （80.4% vs 44.4%，P<0.05）.The positive rate of Ⅲ/Ⅳ stage gastric cancer was higher than that of Ⅰ/Ⅱ stage （86.5% vs 56.5%，P<0.01）.Five-year survival rate in Survivin positive cases was lower than that in Survivin negative cases （39.0% vs 63.2%，P<0.05）.The positive rate of positive H.pylori infection gastric cancer was higher than that of negative H.pylori infection gastric cancer （75.6% vs 46.7%，P<0.05）. Conclusion Suvivin expression is related with the occurrence and development of gastric cancer，a detection of the expression may be used as an objective index for predicting the prognosis of this disease.H.pylori infection can promote Suvivin expression.

[Key words] Stomach Neoplasms；Survivin；Helicobacter pylori；Immunohistochemistry

胃癌是我国常见的恶性肿瘤之一，胃癌的发生发展与细胞的增殖凋亡密切相关。Survivin是凋亡抑制蛋白（inhibitor of apoptosis proteins，IAPs）成员之一，是迄今为止最强的凋亡抑制因子，Survivin不但能抑制肿瘤细胞的凋亡，而且还参与肿瘤新生血管的形成。幽门螺杆菌（Helicobacter pylori，H.pylori）感染是慢性胃炎、消化性溃疡的主要病因，亦与胃癌的发生有关。本研究采用免疫组化法检测Survivin在胃癌组织中的表达，探讨其表达与胃癌临床病理特征之间的关系及患者术后5年生存率之间的关系，并分析其与H.pylori感染的关系，阐明Survivin在胃癌发生发展中的作用及机制，为从分子水平进一步研究胃癌的发生发展、预后和治疗寻求新的思路。

1 资料与方法

1.1 一般资料

60例胃癌组织标本取自我院2008年1～12月收治的胃癌患者，患者均采取胃癌根治术治疗，患者术前均未接受放疗、化疗或其他针对胃癌的特殊治疗。……