Survivin and caspase-3 and PanIN. Disorders of apoptosis in the process of pancreatic cancer formation.

Introduction: It is believed that pancreatic intraepithelial neoplasia is an important element of pancreatic carcinogenesis. Apoptosis is the process of programmed cell death. Survivin is one of the proteins that inhibit apoptosis. Caspase-3 is a cysteine protease, and plays important roles in the process of apoptosis. Aim of the research: The authors focus on analyzing the expression of survivin and caspase-3 in unchanged tissue and tissue from PanIN lesions. This study may help to better understand the cause-and-effect chain from low-grade intraepithelial neoplasia to high-grade neoplasia and invasive cancer. Material and methods: The study used tissue material obtained from 70 patients operated on at the 2nd Department of General, Gastroenterological and Oncological Surgery at the Medical University of Bialystok due to pancreatic diseases: adenocarcinoma (38 patients), chronic pancreatitis (23 patients), pancreatic cysts (9 patients). A total of 239 tissue samples were isolated for clinical examination. Results: There were statistically significant differences in survivin expression by sex (p < 0.05) and age (p < 0.05). The level of survivin expression was higher in male patients and patients over 60. There were statistically significant differences between the expression levels of survivin as well as caspase-3 depending on the degree of PanIN [PanIN 1A vs PanIN 1b survivin 15% vs. 38.8% (p < 0.05), and caspase-3 17%; vs. 26.9% (p < 0.05). PanIN 2 vs. PaIN3 survivin 62.4% vs. 85.7% (p < 0.05), caspase-3 36.1% vs. 54.3% (p < 0.05)]. Conclusions: The expression level of survivin and caspase-3 is inextricably linked with the progression of pancreatic intraepithelial neoplasia. The more advanced neoplasia is, the higher is the expression level. [ABSTRACT FROM AUTHOR]