Survivin and p53 expression in patients with Crohn's disease: an immunohistochemical study

Crohn’s disease (CD) is characterized by acute phases of patchy transmural inflammation, involving any part of the intestinal tract with intervening periods of remission. It has been well established that patients with Crohn’s disease are at increased risk of developing intestinal adenocarcinoma. The regulation of apoptotic cell death may have an important effect on the pathogenesis and progression of colon cancer. Disturbance of apoptosis is known to be very crucial in neoplastic progression and transformation. Mutations in the proapoptotic and tumor suppressor gene p53 are associated with neoplasia in ulcerative colitis, but little is understood of their significance in Crohn’s disease. Members of the inhibitor of the apoptosis protein (IAP) family including survivin are expressed in many tumors. It is known that well differentiated adenocarcinoma tend to express higher level of survivin than normal mucosa. Expression of survivin was observed in the cytoplasm of adenoma with dysplasia and colonrectal carcinoma cells. In order to explore the role of p53 and survivin as marker of neoplasia in CD patient, the aim of this study was to evaluate, by immunohistochemical analysis, the expression and distribution of p53 and survivin immunoreactive cells in a series of Crohn’s disease bioptic tissues with apparently normal adjacent tissues. The immunohistochemical study showed an increase in p53 and survivin expression. Our results suggest that p53 and survivin overexpression in CD patients may predispose the intestinal mucosa to dysplasia that may progress to a higher grade of neoplasia overtime.