ABSTRACT
<p><b>OBJECTIVE</b>To investigate the expression and significance of survivin, ki-67 and apoptosis index in patients with advanced gastric adenocarcinoma.</p><p><b>METHODS</b>Immunohistochemical SP method for survivin expression as well as cell proliferative index (ki-67) and apoptosis index (TUNEL) was conducted on 120 gastric adenocarcinomas.</p><p><b>RESULTS</b>The survivin was detected in the cytoplasm of carcinoma cells in 59 (49.17%) of the 120 gastric adenocarcinomas, in 32 (64.00%) of the lymph node metastasis, and in 21 (17.50%) of the 120 basal layer in normal gastric mucosa, respectively. The mean proliferative index (ki-67) in primary tumors was 7.55%, which was significantly lower than the mean proliferative index of 8.34% observed in lymph node metastasis. The mean apoptosis index in primary tumors was 1.16%, which was significantly higher than the mean apoptosis index of 0.89% observed in lymph node metastasis. The frequency of survivin expression was significantly higher in lymph node metastasis than in primary gastric adenocarcinoma. Expression of survivin was significantly correlated with histological subtypes, the depth of invasion, or lymph node metastasis (P < 0.05). There was negative correlation between weighted survivin score and apoptosis index (P < 0.05), but no correlation with proliferative index.</p><p><b>CONCLUSION</b>The high level expression of survivin might be a referenced indicator in evaluating differentiation of tumor and in predicting lymph nodes metastasis and estimating apoptosis index.</p>