Survivin蛋白在肝外胆管癌组织中的表达及其与预后的关系

目的 观察Survivin蛋白在肝外胆管癌组织中的表达,探讨Survivin蛋白表达水平与肝外胆管癌临床病理特征的相关性,研究Survivin蛋白表达与肝外胆管癌预后的关系.方法 采用免疫组化法检测59例肝外胆管癌组织和相应的20例癌旁组织中Survivin蛋白的表达,分析肝外胆管癌组织中Survivin蛋白的表达水平与患者临床病理特征、淋巴结转移的关系及其与预后的关系.结果 肝外胆管癌组织Survivin蛋白表达阳性率为67.8%(40/59),而癌旁组织为20.O%(4/20),二者有明显差别(P<0.01).Survivin蛋白表达水平与分化程度呈负相关(P<0.01),与TNM分期、淋巴管浸润、神经浸润和淋巴结转移旱正相关(P<0.05).Survivin蛋白表达阳性组血清CA19-9的水平为(290 300±55 500)U/L,阴性组为(113 300±31 400)U/L,Survivin蛋白阳性表达组高于阴性表达组(P<0.05).Survivin蛋白表达阴性组和阳性组平均生存期分别为43.5个月和21.1个月,差异有统计学意义(P<0.01).多因素生存分析结果显示,Survivin蛋白、癌残留及淋巴结转移是肝外胆管癌独立的预后因素(P<0.05,P<0.01,P<0.01).结论 Survivin蛋白表达水平与分化程度呈负相关,与淋巴浸润和血清CA19-9浓度呈正相关.Survivin蛋白表达水平为肝外胆管癌根治术后独立的预后因素.

Expression of Survivin protein in extrahepatic cholangiocarcinoma and its relationship with the prognosis

Objectives To investigate the expression of Survivin in patients with extrahepatic cholangiocarcinoma ( EHCC ) and its relationship with clinicopathological features of EHCC, and the correlation between the expression of Survivin and lymph node micrometastasis, tumor markers, and the prognosis of EHCC. Methods The expression of Survivin protein in paraffin-embedded specimens of 59 patients with EHCC and their 20 para-carcinoma tissues were evaluated by S-P method of immunohistochemieal staining. The correlation between the expression of Survivin and the lymph node micrometastasis, clinicopathological features of EHCC and the prognosis of EHCC were analyzed. Results The positive expression rate of Survivin protein was 67. 8% (40/59) in paraffin-embedded specimens of 59 patients with EHCC and was 20. 0% (4/20) in para-carcinoma tissues, and difference between carcinoma tissues and para-carcinoma tissues was significant (P < 0. 01). Histologjcal differentiation in EHCC had a negative correlation with the expression of Survivin protein,while the expression of Survivin protein in EHCC had a positive correlation with TNM of EHCC, lymphatic vessel infiltration, lymph node metastasis and perineural invasion (P <0.05). The serum CA19-9 levels in the positive group with expression of Survivin protein was (290 300 ± 55 500) U/L and was obviously higher than that in the negative group [ (113 300 ±31 400)U/L,P <0. 05]. The mean survival time of the patients with negative expression of Survivin protein was higher than that of the patients with positive expression (43. 5 vs. 21. 1 months,P <0. 01). Screened to significance univariate, the multivariate analysis through Cox proportional hazard model analysis showed that lymph node metastasis, residual tumor margins, and expression of Survivin protein were independent prognosis factors of the patients with EHCC(P<0.05,P<0.01 ,P <0. 01). Conclusions The expression of Survivin protein in EHCC has a negative correlation with histological differentiation, while has a positive correlation with lymphatic vessel infiltration and serum CA19-9 concentrations. The expression of Survivin protein maybe an independent prognosis factor of the patients with EHCC.