Survivin在结直肠癌中的表达及其临床意义

目的 探讨结直肠癌组织中凋亡抑制因子survivin的表达及其与各临床病理因素的关系,评价survivin在结直肠癌预后判断中的价值。方法 应用组织芯片结合免疫组织化学SABC法,检测126例早期结直肠癌组织中survivin的表达情况,回顾性分析survivin与各临床病理因素及预后之间的关系。结果 根据免疫组化染色强度和分级结果,所有病例被分为survivin高表达组和低表达组。其中高表达组有26例(26/126,20.6%),低表达组有100例(100/126,79.4%)。survivin在结直肠癌中表达情况与年龄、性别、肿瘤大小、肿瘤部位、组织学类型、浸润深度、淋巴是否转移、Dukes分期均无显著相关。然而,高表达的survivin与肿瘤复发、特别是血行转移显著相关(P<0.05)。Survivin高表达组和低表达组的生存率用Kaplan-Meier方法评估,并用log-ranktest进行比较,两组之间生存率具有显著差异(P<0.05)。多因素分析结果显示,在潜在的预后因素中(年龄、性别、肿瘤大小、肿瘤部位、组织学类型、淋巴是否转移、Dukes分期、survivin表达),survivin表达和Dukes分期被认为是结直肠癌根治术后独立预后因素。结论 Survivin的表达与结直肠癌的术后复发相关:结直肠癌术后复发率在survivin高表达组明显高于survivin低表达组,是与预后相关的独立危险因子。应用织芯片高效检测临床组织样本具有快速、方便、经济、准确的优点。

Expression of survivin and its clinical significance in colorectal carcinoma

Objective To investigate the relationship between the expression of survivin and the clincopathological factors of colorectal carcinoma and evaluate the significance of survivin in prognotic assessment of the patients. Methods Using tissue microarray and immunohistochemical method (SABC), we examined survivin expression in 126 patients with advanced colorectal cancer and retrospectively analyzed the relationship between survivin and both the clinicopathological features and prognosis of the malignancy. Result Of the 126 patients, 26 (21%) were found to have a high survivin expression and 100 (79%) had a low expression, without relation to the patients' age, gender, tumor size, tumor location, histological type, lymph node metastasis and Dukes' classification. High survivin expression was strongly correlated with tumor recurrence and especially with hematogenous metastasis (P<0.05). Kaplan-Meier method and log-rank test indicated significantly different disease-free survival rates between high- and low-survivin groups (P<0.05), and Dukes' stage and survivin expression of the tumor were identified in multivariate analysis as the independent significant factors related to disease-free survival. Conclusions Survivin expression in colorectal cancer has strong positive correlation with tumor recurrence as the independent risk factor related to prognosis. Tissue microarray enables rapid, convenient, economic and accurate large-scale examination of clinical specimens.