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 2^nd 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.