Abstract. The present study aimed to investigate the impact of survivin and caspase-3 on apoptosis and angiogenesis in oral cancer. A total of 16 oral leukoplakia cases accompanied by low-moderate epithelial dysplasia, 12 cases of oral leukoplakia accompanied by severe epithelial dysplasia, 17 cases of high-moderate differentiated oral squamous cell carcinoma and 10 cases of normal oral mucosa were selected. Immunohistochemistry was used to detect the expression levels of survivin, caspase-3, and caspase inhibitor factor VIII in lesions from each group. Terminal deoxynucleotidyl transferase 2'-deoxyuridine, 5'-triphosphate nick end labeling was performed to detect the apoptotic index of oral leukoplakia and cancer tissue. Immunohistochemistry revealed increased expression levels of survivin in oral cancer tissues, as compared with the normal mucosa, whereas the expression of Caspase-3 was decreased during malignant transformation. Microvascular density (MVD) was increased from 28.49±11.87 strips/mm 2 (mean ± standard deviation, normal control group) to 91.98±40.20 strips/mm 2 (oral cancer group). Therefore, survivin may serve an important role in oral cancer, as its expression was increased in association with a downward trend in caspase-3 expression and apoptotic index, whereas MVD was significantly increased.
IntroductionAn imbalance between cell proliferation and apoptosis is important during the occurrence and development of oral cancer. This dynamic balance is essential to maintaining homeostasis, which ensures the balance and stability of the human body at the cellular level. Previous studies have observed that the reduction of apoptosis also serves a key role in oral cancer incidence and development. A previous study demonstrated that pro-apoptotic factors, including tumor protein 53 and Fas, as well as anti-apoptotic factors, including the B-cell lymphoma-2 family and inhibitors of apoptosis protein family (IAPs), serve crucial roles in the pathogenesis of oral cancer (1). Of the IAPs, survivin is the protein with the highest apoptosis inhibitory ability, and also regulates the cell cycle (2). Previous studies compared the expression profile of survivin in normal oral mucosa, oral precancerous lesions and oral cancer tissue, revealing that survivin was not expressed in the normal oral mucosa but was expressed in the early and precancerous stages of oral cancer (3-5). The positive expression rate of survivin in epithelial paraplastic tissues was ~97 and ~98% in oral cancer tissue (3-5), and its expression in distinct splice variants was also altered during tumorigenesis (6). This indicates that survivin not only serves an important role in the occurrence of oral cancer, but that the increase in its expression levels are an early event in the development of this type of cancer. A previous study also observed that survivin was associated with angiogenesis, as it was not able not be detected in quiescent endothelial cells, but was strongly expressed in angiogenic factor-stimulated endothelial cells (7). In a...