c-FLIP/BCL-2/Ki-67在膀胱移行细胞癌中的表达与临床病理学特征及对预后影响的研究

目的 研究膀胱癌中c-FLIP、BCL-2、Ki-67的表达与肿瘤分期、分级和生长方式以及病人预后的关系,从而为膀胱移行细胞癌侵袭性和预后的判断提供科学理论依据.方法 收集56例临床资料完整石蜡包埋的肿瘤标本,用免疫组化SABC法测定c-FLIP、BCL-2和Ki-67的表达,采用SPSS12.0软件包分析其表达与肿瘤组织学性状的关系以及对病人预后的影响.结果 c-FLIP、BCL-2和Ki-67的阳性表达在56个病例中分别为：64%（36/56）、43%（24/56）和59%（33/56）;c-FLIP和BCL-2的阳性表达在不同分期组间差异具有显著性（P=0.012,P=0.035）,而在不同的分级和不同的生长方式组间二者的阳性表达差异无显著性（P＞0.10）;Ki-67的阳性表达在不同的分级和分期组间差异均有显著性（P=0.048,P=0.020）;单因素生存分析发现生长方式、分期、c-FLIP、Bcl-2、Ki-67对生存影响具有显著性意义（P＜0.05）,多因素生存分析发现c-FLIp、生长方式和分期对生存影响具有显著性意义.结论 c-FLIP对评价膀胱癌的侵袭性和对预后的影响是一个重要的独立因素,Bcl-2、Ki-67对评价膀胱癌的侵袭性和预后也有一定的意义.检测膀胱移行细胞癌组织中的c-FLIP、Bcl-2和Ki-67的表达可作为估计病情发展判断患者预后的重要指标.

Research of c-FLIP, BCL-2 and Ki-67 expression in bladder urothelial carcinomas and their relation with clinical pathology and prognosis

[Objective] To investigate the expression of c-FLIP,BCL-2 and Ki-67 in bladder urothelial carcinomas in relation with tumor grade, stage and growth type. To investigate these factors in relation to patient outcome in bladder urothelial carcinomas; And then to provide scientific theory evidence for judgment on severity of the tumor and prognosis of patient with bladder urothelial carcinomas. [Method] The expression of c-FLIP, BCL-2 and Ki-67 was quantified immunohistochemiclly in paraffin-embedded tumor tissues from 56 patients for whom clinical information was available. The relationship between their expression and histologic findings and the effect of these factors on clinical outcome was assessed by SPSS12.0 software. [Result] Positive incidence of expression in bladder urothelial carcinomas was detected for c-FLIP, BCL-2 and Ki-67 was in 64%(36/56), 43%(24/56) and 59%(33/56)of cases, respectively. The positive expression of c-FLIP and BCL-2 affected the advancing stage significantly(P =0.012, P =0.035). The positive expression of Ki-67 affected the tumor grade, stage and growth type significantly (P =0.048, P =0.020). We found tumor growth type, stage, c-FLIP, Bcl-2 and Ki-67 affected patient outcome significantly in univariate survival analysis (P <0.05), and we found tumor growth type, stage, c-FLIP affected patient outcome significantly in multivariate survival analysis. [Conclusion] c-FLIP is an important independent factor for its value of assessing the severity of tumor and prognosis. Bcl-2, Ki-67 is also significant for assessing the severity of tumor and prognosis to some extent. C-FLIP, Bcl-2 and Ki-67 can be regarded as important factors for estimating development of diseases and judging prognosis of patient through detecting their expression in bladder urothelial carcinoma.