凋亡相关因子Caspase-3、Survivin在急性胰腺炎患者中的表达及意义

摘要

目的 探讨急性胰腺炎患者凋亡相关因子Caspase-3和Survivin的表达及其临床意义.方法 选取82例急性胰腺炎患者,其中轻症38例,重症44例.所有患者均术中留取胰腺组织标本进行免疫组化.观察轻症与重症患者的HE染色与免疫组化表现,比较HE病理评分、Caspase-3、Survivin平均光密度及Caspase-3、Survivin阳性率.结果 轻症患者的HE染色表现为胰岛组织出血,胰腺腺泡、小叶、细胞等间隙发生明显增宽;重症患者为正常结构消失、组织坏死、中性粒细胞浸润.轻症患者的Caspase-3免疫组化表现为胰腺腺泡组织胞浆深染,重症患者为淡染;轻症与重症患者Survivin免疫组化均表现为胰腺组织胞浆黄染,但重症患者颜色更深.轻症患者的HE病理评分、Survivin平均光密度低于重症患者(P<0.05),Caspase-3平均光密度高于重症患者(P<0.05).轻症患者Caspase-3阳性率55.26%,高于重症患者31.82%(P<0.05).轻症患者Survivin阳性率26.32%,低于重症患者52.27%(P<0.05).结论 急性胰腺炎患者早期已出现凋亡系统紊乱,表现为轻症患者的Caspase-3高表达与Survivin低表达.随着病情进展,Caspase-3表达减弱、Survivin表达加强,二者有负反馈调节作用.%Objective To observe the expression of apoptosis-related factors Caspase-3 and Survivin in patients with acute pancreatitis.Methods 82 patients with acute pancreatitis were selected, 38 cases were mild and 44 cases were severe.All patients were given pancreatic tissue samples during surgery for immunohistochemistry.The manifestations of HE staining and immunohistochemical in mild and severe patients were observed, the HE pathological score, average optical density and positive rate of Caspase-3 and Survivin were compared between mild patients and severe patients.Results The HE staining of mild patients showed hemorrhage of pancreatic islets, pancreatic acinar, leaflets, cells and other gaps were significantly widened, while the severe patients showed that normal structure disappeared, tissue necrosis, neutrophil infiltration.The Caspase-3 immunohistochemistry in patients with mild pancreatic showed acinar tissue cytoplasm deep staining, severe patients with light stains.Survivin immunohistochemistry in mild and severe patients showed cytoplasmic yellowing of pancreatic tissue, while the severe patients was deeper.The HE staining, average optical density of Survivin in mild patients were lower than those of severe patients (P<0.05), the average optical density of Caspase-3 was higher than of severe patients (P<0.05).The positive rate of Caspase-3 in mild patients was 55.26%, which was higher than that of severe patients (31.82%, P<0.05).The positive rate of Survivin in mild patients was 26.32%, which was lower than that of severe patients (52.27%, P<0.05).Conclusion The apoptosis system of acute pancreatitis patients with early apoptotic system disorders, performanced as high expression of Caspase-3 and low expression of Survivin in mild patients.With the progression of the disease, Caspase-3 expression decreases and Survivin expression increases, both are negative feedback regulation.