非小细胞肺癌survivin和增殖细胞核抗原表达的意义

目的：检测非小细胞肺癌（NSCLC）组织中survivin蛋白和增殖细胞核抗原（PCNA）蛋白的表达及探讨其临床病理学意义。方法：采用免疫组织化学SP法，分别检测43例NSCLC组织、15例正常支气管上皮组织中survivin和PCNA蛋白的表达。43例均随访或追观5年以上。结果：NSCLC的survivin阳性表达率（79.1%，34/43）明显高于正常支气管上皮组织阳性表达率（13.3%，2/15）(P＜0.01）；Ⅲ期survivin表达明显高于Ⅰ+Ⅱ期（P＜0.05）；Survivin++～+++组的生存期明显较survivin－～+组短；Survivin的表达与其它临床病理参数均无明显关系（P＞0.05）。NSCLC的PCNA增殖指数显著高于正常支气管黏膜上皮组织（P＜0.01）；增殖指数与肿瘤大小、淋巴结转移、临床分期呈正相关（P＜0.01），与生存期呈负相关（P＜0.01）。增殖指数与其它临床病理参数均无明显关系（P＞0.05）。Survivin蛋白++～+++组中，增殖指数明显高于survivin－～+组（P＜0.05）。结论：Survivin和PCNA蛋白过度表达与NSCLC的发展、预后有密切关系，可作为临床评估NSCLC的进展及判断其预后的重要指标之一。Survivin在NSCLC中表达上调，与细胞增殖关系密切，提示survivin对肺癌的发生发展起重要作用。

Expression of survivin and proliferating cell nuclear antigen in human non-small cell lung cancer

OBJECTIVE: To determine the expressions of survivin and proliferating cell nuclear antigen (PCNA)in non-small cell lung cancer (NSCLC) and to explore its clinical pathological significance. METHODS: Immunohistochemical SP method was used to detect the expressions of survivin and PCNA in 43 patients with NSCLC and 15 normal epithelial tissues of the lung. PCNA labeling proliferative index was assessed. Forty-three patients with NSCLC were followed up for more than 5 years. RESULTS: The positive expression of survivin in NSCLC (79.1%) was significantly higher than that in normal epithelial tissues of the lung (P < 0.01). The survivin expression in Stage I + II was lower than in Stage III (P < 0.05). The overall survival time was significantly shorter in patients with high survivin expression than that in patients with absent or low survivin expression. The survivin expression was not related to sex, age, tumor size and site, histological type, grade, and lymphoid node metastasis (P > 0.05). The mean proliferative index of PCNA in NSCLC was much higher than that in normal epithelial tissues of the lung (P < 0.01). A positive correlation was present between the proliferative index and the tumor size, lymph node metastase, and clinical stage (P <0.01), while a negative correlation between the proliferative index and survival time (P <0.01). There was no correlation between proliferative index and age, sex, site, histological type and grade. The proliferative index was larger in patients with moderate or strong positive survivin expression than that in patients with negative or weak survivin expression (P < 0.05). CONCLUSION: Over expression of survivin and PCNA is closely correlated to the progression and prognosis of patients with NSCLC, which is helpful to evaluate the progression of cancer and to predict the prognosis of NSCLC. The up-regulation of survivin expression and its close relationship with the cell proliferation in NSCLC suggest that survivin may play an important role in the carcinogenesis and development of lung cancer.