Survivin与结直肠癌的研究现状

目的:Survivin是一种凋亡抑制基因,是凋亡抑制基因家族中分子量最小而抗凋亡作用最强的成员。其表达具有特异性,即在几乎所有恶性肿瘤组织都存在高表达,而在正常成人组织中不表达。Survivin具有抑制细胞凋亡,调控细胞周期,促进细胞分化以及增强血管发生的多重作用,参与了结直肠癌的发生与发展,并与其诊断、治疗和预后相关。Survivin已成为具有潜在价值的肿瘤标志物和肿瘤治疗的新靶点,在大肠癌诊断及治疗方面具有广阔前景。     

Survivin和Livin在Dukes'B期结直肠癌中的表达及其临床意义

背景与目的：Survivin和Livin是新发现的凋亡抑制蛋白（inhibitors of apoptosis proteins,IAPs）家族成员,特异性表达于肿瘤细胞和胚胎细胞,在正常细胞中较少表达,其表达与部分肿瘤预后不良相关.本研究检测Survivin及Livin在Dukes＇B期结直肠癌组织中的表达并分析其临床意义.方法：收集81例根治性手术切除后的Dukes＇B期结直肠癌组织,利用免疫组化SP法检测Survivin及Livin的表达并分析两种蛋白与临床特征的关系及对患者生存的影响.结果：Survivin和Livin在Dukes＇B期结直肠癌组织中的阳性率分别为58.0%和45.7%,明显高于正常对照组的16.7%和8.3%（P值均＜0.05）;两者表达不具有相关性（P＞0.05）;Survivin及Livin在结直肠癌组织中的表达与性别、肿瘤部位、肿瘤大小、T分期、大体类型、组织分化程度均无显著性相关（P值均＞0.05）;≥50岁患者Survivin的阳性率高于＜50岁患者（70.6%vs.36.7%,P＜0.05）;Survivin和Livin的表达均与肿瘤复发和/或转移（P=0.02,P=0.001）、总生存不佳有关（P=0.039,P=0.001）;Cox多因素分析显示T4及Livin阳性为Dukes＇B期结直肠癌独立不良预后因素（P=0.002,P=0.047）.结论：Survivin及Livin高表达于Dukes＇B期结直肠癌组织中,Livin与根治性手术后的复发转移和患者预后关系密切.     

Survivin和Livin在Dukes''B期结直肠癌中的表达及其临床意义

背景与目的:Survivin和Livin是新发现的凋亡抑制蛋白(inhibitors of apoptosis proteins,IAPs)家族成员,特异性表达于肿瘤细胞和胚胎细胞,在正常细胞中较少表达,其表达与部分肿瘤预后不良相关.本研究检测Survivin及Livin在Dukes'B期结直肠癌组织中的表达并分析其临床意义.方法:收集81例根治性手术切除后的Dukes'B期结直肠癌组织,利用免疫组化SP法检测Survivin及Livin的表达并分析两种蛋白与临床特征的关系及对患者生存的影响.结果:Survivin和Livin在Dukes'B期结直肠癌组织中的阳性率分别为58.0%和45.7%,明显高于正常对照组的16.7%和8.3%(P值均＜0.05);两者表达不具有相关性(P＞0.05);Survivin及Livin在结直肠癌组织中的表达与性别、肿瘤部位、肿瘤大小、T分期、大体类型、组织分化程度均无显著性相关(P值均＞0.05);≥50岁患者Survivin的阳性率高于＜50岁患者(70.6%vs.36.7%,P＜0.05);Survivin和Livin的表达均与肿瘤复发和/或转移(P=0.02,P=0.001)、总生存不佳有关(P=0.039,P=0.001);Cox多因素分析显示T4及Livin阳性为Dukes'B期结直肠癌独立不良预后因素(P=0.002,P=0.047).结论:Survivin及Livin高表达于Dukes'B期结直肠癌组织中,Livin与根治性手术后的复发转移和患者预后关系密切.     

Survivin在结直肠癌组织中表达的临床意义及其与细胞凋亡、血管生成的关系

背景与目的:关于survivin在结直肠癌中的表达及其与病理因素、细胞凋亡及血管生成的关系仍然不清楚。本研究旨在通过探讨survivin在结直肠癌中的表达对细胞凋亡的影响及其与血管生成的关系,以认识survivin对结直肠癌发展及预后的影响。方法:应用免疫组化技术检测survivin、血管内皮生长因子(vascular endothelial growth factor.VEGF)在91例结直肠癌组织中的蛋白表达,TUNEL法检测癌细胞凋亡指数(apoptosis index,AI)。结果:结直肠癌伴远处器官转移者的survivin蛋白表达(56%,14/25)高于未转移者(48.5%,32/66)(P<0.05),5年生存者survivin蛋白表达阳性率穴(n阳性患者平均生存期为91.3月熏阴性患者为116.4月,前者的5年生存率穴65.2%熏30/46雪显著低于survivin阴性者穴88.9%熏40/45雪穴P<0.01雪;survivin阳性患者的AI均数(0.74±0.19)%显著低于阴性患者(1.07±0.24)%穴P<0.01雪;survivin与VEGF蛋白表达显著相关穴Pearson系数:0.721雪。结论:survivin可抑制结直肠癌细胞凋亡和调节肿瘤血管生成。     

FHIT基因在结直肠癌中的表达及其与细胞凋亡抑制的相关性

Objective： To investigate the expression of fragile histidine triad （FHIT） protein in normal colorectal tissue, colorectal adenoma and colorectal cancer （CRC）, and to study the relationships between the expression of FHIT protein and the clinical pathology, the apoptosis-associated protein （Bcl-2, Bax, Survivin）, apoptosis in colorectal cancer. Methods： Tissue microarray （TMA） and immunohistochemistry SP were used to detect the expression of FHIT gene, Bcl-2, Bax and Survivin in 16 cases of the normal colorectal tissue, 16 cases of colorectal adenoma and 80 cases of the colorectal cancer. TUNEL was used to detect the apoptosis index （Al） in 80 cases of the colorectal cancer. Results： （1） The positive rates of FHIT gene expression in normal colorectal tissue, colorectal adenoma and adenocancer were 93.75%, 68.75% and 46.25% respectively. There were no significant differences in the relationships between the FHIT gene expression and histological types, the gender as well as the age （P〉0.05）. There were significant relationships between FHIT gene expression and lymph node metastasis, histological grades, Duke＇s system as well as the 5-year survival rate after operation. （2） The positive rates of Bax, Bcl-2 and Survivin in colorectal adenocancer were 72.50%, 51.25%, 77.50% respectively. The expression of FHIT gene was positively correlated with that of Bcl-2, Bax and Survivin. （3） The mean AI in FHIT negative tumors was significantly lower than that in FHIT positive tumors （P〈0.01）. Conclusion： FHIT gene may play a role in the oncogenesis and progression of colorectal cancer. The abnormal regulation of apoptosis may play an important role in the pathogenesis of colorectal cancer.     

可溶性Fas与结直肠癌转移的关系

目的：探讨结直癌转移与可溶性Ｆａｓ（ｓＦａｓ）间的相关性。方法：应用酶联免疫吸附试验（ＥＬＩＳＡ）对４０例对照组和１２例结直肠癌患者血清中ｓＦａｓ浓度进行了测定。结果：对照组、原位癌和结直肠癌转移者血清中ｓＦａｓ浓度分别为２．３９７±１．３７９ｎｇ／ｍｌ、３．１５９±１．９０４ｎｇ／ｍｌ和７．９１４±２．１０５ｎｇ／ｍｌ。原位癌血清中ｓＦａｓ浓度高于对照组（Ｐ＜０．０１）,而低于转移性直肠癌组（Ｐ＜０．０５）,同时后者又明显高于对照组（Ｐ＜０．０１）。结论：ｓＦａｓ与结直肠癌转移有关,可能成为诊断其转移指标之一。     

结直肠癌预后因素与治疗

目的：了解结直肠癌的预后因素与治疗现状。方法：回顾性分析我院2000年1月-2005年12月收治的333例结直肠癌患者的临床资料,观察临床病理特征和治疗方案对预后的影响。结果：K—M单因素分析显示结直肠癌的预后因素是症状、症状持续时间、术前CEA水平、分期、部位、肿瘤大小、病理分级、病理分型、是否联合化疗、Ⅲ期患者是否行辅助化疗、晚期结直肠癌治疗模式、直肠癌治疗模式;COX模型多因素分析显示影响生存的独立因素为术前CEA水平、分期、是否联合化疗、直肠癌治疗模式;333例结直肠癌患者的平均生存期为58．365±2．159个月,1年、3年、5年生存率分别为82．47％、63．48％和56．60％,其中综合治疗患者占46．39％,单纯手术患者占51．20％。结论：治疗模式是结直肠癌重要的独立预后因素,而标准的治疗模式应该得到进一步的重视和应用。     

结直肠癌预后因素与治疗

目的:了解结直肠癌的预后因素与治疗现状.方法:回顾性分析我院2000年1月-2005年12月收治的333例结直肠癌患者的临床资料,观察临床病理特征和治疗方案对预后的影响.结果:K-M单因素分析显示结直肠癌的预后因素是症状、症状持续时间、术前CEA水平、分期、部位、肿瘤大小、病理分级、病理分型、是否联合化疗、Ⅲ期患者是否行辅助化疗、晚期结直肠癌治疗模式、直肠癌治疗模式;COX模型多因素分析显示影响生存的独立因素为术前CEA水平、分期、是否联合化疗、直肠癌治疗模式;333例结直肠癌患者的平均生存期为58.365±2.159个月,1年、3年、5年生存率分别为82.47%、63.48%和56.60%,其中综合治疗患者占46.39%,单纯手术患者占51.20%. 结论:治疗模式是结直肠癌重要的独立预后因素,而标准的治疗模式应该得到进一步的重视和应用.     

结直肠癌辅助治疗现状

结直肠癌是最常见恶性肿瘤之一,近年来国内外发病率逐年上升.尽管确诊时70%～80%的患者可以进行根治性手术切除,但总体的5年生存率仍只有50%～60%.约2/3接受过根治手术的患者会发生复发或远处转移,85%的复发转移发生在术后2年半之内,这些复发转移的发生可能与确诊时已存在微转移灶有关,而目前的检查手段还无法发现这种微转移.在无辅助化疗之前,Ⅲ期结直肠癌术后3年无病生存率(disease-free survival,DFS)约为44%～52%,而术后辅助治疗的目的在于预防根治性切除术后肿瘤的局部复发和远处转移,从而延长患者的生存时间.     

免疫组化检测Survivin和Livin表达可预测Dukes'''' B期结直肠癌术后的复发和生存

Objective： To detect the expressions of Survivin and Livin in Dukes＇ B colorectal cancer tissues and analyze the prognosis after curative resection. Methods： The expressions of Survivin and Livin were evaluated immunohistochemically in Dukes＇ B colorectal cancer specimens from 81 patients after curative resection of the tumor. Their correlations to clinical characters and survival were also explored. Results： The positive rates of Survivin and Livin in colorectal cancer tissues were significantly higher than those in normal colorectal tissues （58.0% vs. 16.7% and 45.7% vs. 8.3% respectively, P 〈 0.05）. The expressions of Survivin and Livin were not related to gender, tumor site, primary size, T stage, pathologic category, and degree of differentiation （P 〉 0.05）, and no relationship was found between the expressions of Survivin and Livin （P 〉 0.05）. The expression rate of Survivin in patients older than 50 years was higher than that in patients younger than 50 years （70.6% vs. 36.7%, P 〈 0.05）. Both Survivin and Livin were related to recurrence and/or metastasis （P = 0.02 and P = 0.001, respectively）, and shorter survival （P = 0.039 and P = 0.001, respectively）. Cox multivariate analysis showed T4 and positive Livin expression were independent prognostic factors （P = 0.002 and P = 0.047, respectively）. Conclusion： Survivin and Livin are over-expressed in Dukes＇ B colorectal cancer tissues and are positively related to recurrence and/or metastasis and poor prognosis after curative resection of the tumor.     

乳腺癌组织survivin表达与紫杉醇化疗敏感性的关系

目的探讨抗凋亡蛋白survivin在乳腺癌组织中的表达及其与紫杉醇化疗敏感性的关系.方法应用免疫组化方法,对40例用紫杉醇化疗的乳腺癌患者癌组织survivin表达情况进行检测,分析其与紫杉醇化疗敏感性的关系.结果乳腺癌患者survivin表达阳性率为60.O%(24/40);survivin阴性组患者紫杉醇化疗后完全缓解率、有效率、控制率和获益率分别为50.0%、68.8%、93.8%和81.3%,survivin阳性组患者分别为25.0%、45.8%、75.0%和62.5%,两组相比各项指标均有显著差异(P＜0.05).结论survivin表达水平与乳腺癌对紫杉醇化疗敏感性呈显著负相关,survivin可能作为一项预测紫杉醇疗效、筛选乳腺癌化疗药物、指导制定合理治疗方案的新指标.     

Prognostic importance of survivin in breast cancer

Survivin is a member of the inhibitor of apoptosis (IAP) family, and is also involved in the regulation of cell division. Survivin is widely expressed in foetal tissues and in human cancers, but generally not in normal adult tissue. This study examined the expression of surviving protein in a series of 293 cases of invasive primary breast carcinoma. Survivin immunoreactivity was assessed using two different polyclonal antibodies, and evaluated semiquantitatively according to the percentage of cells demonstrating distinct nuclear and/or diffuse cytoplasmic staining. Overall, 60% of tumours were positive for survivin: 31% demonstrated nuclear staining only, 13% cytoplasmic only, and 16% of tumour cells demonstrated both nuclear and cytoplasmic staining. Statistical analysis revealed that survivin expression was independent of patient's age, tumour size, histological grade, nodal status, and oestrogen receptor status. In multivariate analysis, nuclear survivin expression was a significant independent prognostic indicator of favourable outcome both in relapse-free and overall survival (P<0.001 and P=0.01, respectively). In conclusion, our results show that survivin is frequently overexpressed in primary breast cancer. Nuclear expression is most common and is an independent prognostic indicator of good prognosis.     

抗凋亡基因survivin与宫颈癌

Survivin基因是近年来发现的一种抗凋亡基因,与人体大多数肿瘤的发生、预后有关.本文综述近年来有关survivin基因的研究进展及其与肿瘤特别是宫颈癌的关系survivin对肿瘤的诊断及治疗方面的作用.     

腹腔镜下结直肠癌根治术的现状和研究进展

腹腔镜下结直肠癌根治术经过近20年的临床应用，取得了比较肯定的临床疗效，而近年来的研究取得了一定的结果，本文拟对目前腹腔镜下结直肠癌的现状和研究进展作一综述。     

Nuclear localization of survivin is a positive prognostic factor for survival in advanced non-small-cell lung cancer.

BACKGROUND: Expression of survivin, a member of the inhibitor of apoptosis protein family, is commonly detected in cancers but not in normal differentiated tissues. Survivin is usually localized in the cytoplasm of cancer cells, but nuclear localization has also been described, and we recently reported that survivin is a nuclear-cytoplasmic shuttling protein. PATIENTS AND METHODS: Fifty-three tumor specimens from patients with inoperable non-small-cell lung cancer (NSCLC) (55% stage IIIA, 17% stage IIIB and 28% stage IV) who underwent chemotherapy treatment were evaluated with immunohistochemistry for survivin expression and localization. These two sets of data were processed and tested for correlation with major patient characteristics, response to chemotherapy, and overall and relapse-free survival. RESULTS: Survivin was present only in malignant tissues, and 47/53 (89%) of the specimens were positive. The overall median expression of tumor cells was 40%, and this value was used as a cut-off point for statistical analysis. By dichotomizing the specimens as expressing low or high levels of survivin, a significant association was seen between the expression of survivin and the histology of the tumors (P=0.020), squamous cell carcinoma being the histotype with lower levels of survivin expression. Three patterns of localization were observed: 42% of cases (22/53) showed reactivity confined to the nucleus, 17% (nine of 53) only in the cytoplasm and 30% (16/53) in both the nucleus and the cytoplasm. Interestingly, nuclear survivin levels predicted longer overall and relapse-free survival, in univariate and multivariate analyses. Expression and localization of survivin did not correlate with response to chemotherapy. CONCLUSIONS: Our results indicate that differential localization of survivin may be a prognostic factor for NSCLC. Further studies are warranted.