الفهرس 
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Abstract
Cervical cancer is one of the most common cancer affecting women worldwide. At present, few diagnostic and prognostic biomarkers for cervical cancer are in clinical use. Recently, more attention has been increasingly focused on exploring novel biomarkers for the diagnosis and prognosis of cervical cancer.
Loss of apoptosis control and abnormal modulation of cell cycle are involved in the carcinogenesis and the development of tumors. The over expression of apoptosis inhibiting proteins such as survivin can inhibit apoptosis, resulting in abnormal cell proliferation and transduction towards to malignancy. Most factors triggering apoptosis via a signal way mediated by caspase-3.
On studying survivin expression, we found both cytoplasmic and nuclear survivin expression in different lesions. Cytoplasmic survivin was gradually increased with the progression from LSIL (33.3%), to HSIL (87.5% positivity), to SCC (100% positivity). It was significantly associated with some of clinicopathological features of SCC cases, including histopathological subtypes (p = 0.022), high grade (p = 0.042), nodal metastasis (p = 0.035) and tumor stage (p = 0.013).
On the other hand nuclear survivin immunostaining was detected in 66.7% of LSILs, in 62.5%% of HSILs and in 64% of SCC cases. There were no significant differences among different lesions regarding nuclear survivin expression (p=0.117). No significant association between nuclear survivin expression and all clinicopathological features of SCC.
With respect to caspase-3 expression; this study found that the positive expression rate of caspase-3 in LSIL and HSIL cases was higher than in the normal cervical squamous epithelium. There was a gradual increase in the positive expression rate of caspase-3 from (60%) positivity in the normal cervical squamous epithelium to (83.3%) in LSIL cases and (87.5%) in HSIL cases. The percentage of positive caspase-3 expression was significantly reduced in cervical SCC, compared with that in normal cervix and SIL suggesting that a decreased caspase-3 expression is associated with the inhibition of apoptosis during the development of cervical cancer. A significant association was found between caspase-3 and grade of keratinizing SCC (p = 0.016). No significant relationship between caspase-3 immunostaining and other clinicopathological features of SCC, including histopathological subtypes (p = 0.405), lymph node status (p =0.61), tumor stage (p = 0.25) and type of tumor growth (p = 0.397).