Survivin在膀胱移行细胞癌中的表达及其临床意义

目的比较Survivin在正常组织与膀胱移行细胞癌中表达的差异，分析其表达与膀胱移行细胞癌生物学特性及预后的关系。方法选用中山大学附属第三医院2001年至2006年间外科切除及活检的膀胱癌石蜡块标本40例，其中24例为浅表性膀胱癌组织，16例为浸润性膀胱癌组织。另取10例正常膀胱组织石蜡块标本，用免疫组化染色显示组织中Survivin表达，并对结果进行相应的统计学分析。结果10例正常膀胱组织中未见Survivin表达。于G，级、G：级、G，级膀胱癌组织中Survivin的表达率分别为20％（2／10）、38．9％（7／18）、75％（9／12）。经多因素分析，Survivin的表达与膀胱癌细胞的病理分级及患者的无瘤生存时间相关，而与其肿瘤分期及生存率不相关。结论正常膀胱组织不表达Survivin。Survivin的表达率随肿瘤细胞分化程度的降低而升高。Survivin的表达水平反映患者的无瘤生存率，是预测膀胱癌复发的独立预后因子。

The expression and clinic effect of survivin in bladder transitional cell cancer

Objectives To compare the differential expression of Survivin in normal bladder tissue, primary bladder transitional cell carcinoma （BTCC） ; and to analysis the potential clinical significance of expression of Survivin. Methods Immunohistoehemical staining for detecting Survivin expression was carried out on 10 cases of formalin -fixed, paraffin - embedded of normal bladder tissues , 24 consecutive patients who underwent transurethral resection of bladder tumour （TURBt） for Ta, Tis, and/or T1 BTCC, and 16 consecutive patients who underwent radical cystectomy for muscle - invasive BTCC. Results Survivin was expressed in none of the 10 （0） normal bladder specimens, two of the 10（20 % ） G1 BTCC specimens, seven of the 18 （38.9%） G2 BTCC specimens, and nine of the 12 （75%） G3 BTCC specimens. Multivariable analysis revealed that Survivin expression was associated with tumor grade （ P = 0. 02） and tumor-free survival （ P = 0. 04）, but not disease - specific survival （ P = 0. 09） and tumor stage （P = 0. 90）. Conclusions Normal bladder tissue did not express Survivin. Expression of Survivin gradually increased with advancing tumor grade in the primary BTCC. Survivin expression was independently associated with tumor grade and tumor-free survival.