Abstract: Objective: To observe the expressions of survivin and osteopotin(OPN) in normal tissues,low risk colonic adenoma,high risk colon adenoma and cancerated adenoma,and to investigate the value of survivin and OPN in the canceration of colorectal adenoma and the diagnosis of colorectal cancer at the early stage.Methods: According to the diagnostic criteria of "the Guidelines for Colonoscopy Surveillance after Polypectomy"in 2006,the risk stratification of 164 cases of colorectal adenoma who had undergone colonoscopy and verified by pathology was carried out.Seventy-eight cases of colon adenoma including 30 cases of low risk colon adenoma,40 cases of high risk colon adenoma,8 cases of cancerated adenoma and 20 cases of normal tissue were chosen to identify the expressions of survivin and OPN by S-P immunchistochmical method in each group;related analysis was made with reference to the clinicopathologic features.Results: The positive expressions of survivin in normal tissues,low risk colon adenoma,high risk colon adenoma and cancerated adenoma were obviously different(P<0.01).The positive rates of OPN in normal tissues and low risk colon adenoma have no difference(P>0.05).The positive rate of OPN in high risk colon adenoma and cancerated colon adenoma was higher than that in normal tissues(P<0.05 and P<0.01).The positive rate of OPN in low risk colon adenoma and high risk colon adenoma was obviously lower compared with that of cancerated colon adenoma(P<0.05).Conclusions: The expression of survivin in normal tissues,low risk colon adenoma,high risk colon adenoma and cancerated adenoma increases gradually,which indicates that survivin may be an early event in the development of colorectal cancer.It can be regarded as a reference index in colon adenoma and adenoma canceration.The expression of OPN increases gradually in low risk colon adenoma,high risk colon adenoma and cancerated adenoma,indicating that OPN may act as a reference index in colorectal adenoma canceration.