Objects To investigate the expression and significance of survivin in gastric carcinoma and precancerous lesions. Method Two hundred patients diagnosed by pathological examination were collected from the People's Hospital of Foshan, Sanshui District. The patients were divided into five groups (n = 40): chronic superficial gastritis, chronic atrophic gastritis, chronic atrophic gastritis with mild dysplasia, chronic at-rophic gastritis with moderate dysplasia, gastric carcinoma(GC). The expression of survivin was analyzed by immunohistochemistry (IHC). Results The mean score and the positive rate of survivin expression in chronic superficial gastritis group was 0.075 ± 0.267 and the positive rate was 7.5%; chronic atrophic gastritis group 0.600 ± 0.744 and 45%; chronic atrophic gastritis with mild dysplasia group 2.075 ± 1.980 and 95%; gastric carcinoma with moderate gastritis group 5.750 ± 3.614 and 97.5%. The mean level of survivin expression in well differentiated GC group was 2.500 ± 0.707, moderately differentiated GC group 8.750 ± 3.495, poorly differentiated GC group 5.522 ± 3.654, gastric adenocarcinoma group 3.200 ± 0.837; and gastric signet ring cell group 6.000 ± 0.000, respectively. Conclusion The positive rate of the expression of survivin in the process of chronic superficial gastritis -chronic astrophic gastritis -dysplasia -gastric carcinoma is gradually increased, although the expression of survivin in gastric carcinoma is not related to tumor size or the differentiation degree of the tissue.%目的 探讨survivin蛋白在胃癌及癌前病变中的表达程度和意义.方法 收集南方医科大学南方医院消化科及佛山市三水区人民医院消化内镜室诊断并经病理确诊的病例.分为慢性浅表性胃炎组、慢性萎缩性胃炎组、慢性萎缩性胃炎伴轻度不典型增生组、慢性萎缩性胃炎伴中度不典型增生组、胃癌组共5组,每组40例,测定survivin蛋白在各组中的表达程度.结果 survivin表达在慢性浅表性胃炎组平均分值0.075±0.267,阳性率7.5％；在慢性萎缩性胃炎组平均分值0.600±0.744,阳性率45％；在慢性萎缩性胃炎伴轻度不典型增生组平均分值2.075±1.980,阳性率70％；慢性萎缩性胃炎伴中度不典型增生组平均分值4.225±2.402,阳性率95％；在胃癌组平均分值5.750±3.614,阳性率97.5％.survivin表达在胃高分化腺癌中,平均分值2.500±0.707;中分化腺癌平均分值8.750±3.495;低分化腺癌平均分值5.522±3.654;粘液腺癌平均分值3.200±0.837;印戒细胞癌平均分值6.000±0.000.结论 survivin在慢性浅表性胃炎-慢性萎缩性胃炎-不典型增生-胃癌的过程中阳性表达逐渐增高；但其在胃癌中的阳性表达与性别及肿瘤的大小和组织的分化程度无关.
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