乳腺癌组织中survivin和增殖细胞核抗原的表达及其临床意义

目的探讨乳腺癌组织中survivin和增殖细胞核抗原（PCNA）的表达及其临床价值。方法回顾性分析枣庄市立医院2001年1月至2006年12月手术治疗的156例乳腺癌患者的临床病理学资料（患者术前均未行化疗或放射治疗）。采用免疫组织化学SP法检测癌组织石蜡切片中survivin及PCNA的表达。定性资料间的比较，依据不同分析目的分别采用线性趋势检验、Kappa检验或χ^2检验；应用多因素Logistic回归分析与survivin及PCNA阳性表达有关的因素。结果乳腺癌中survivin及PCNA阳性表达与肿瘤病理分型、肿瘤大小无关（P〉0．050），但其与组织学分级、临床分期、淋巴结转移数目相关（P〈0．050）。Survivin及PCNA阳性表达随着癌组织分化程度降低，淋巴结转移数目增加，临床分期增高而增强。多因素Logistic回归分析显示组织学分级是影响survivin及PCNA阳性表达的最主要因素（P〈0．050）。乳腺癌中survivin和PCNA的表达密切关联（Kappa值为0．256，P〈0．001）。Survivin和PCNA双阳性患者复发转移率高于双阴性患者（χ^2=6．510，P=0．011）。结论联合检测survivin及PCNA可作为判断乳腺癌生物学行为和预后的重要指标。

Expression of survivin and proliferating cell nuclear antigen in breast cancer tissues and their clinical significance

Objective To investigate the expression of survivin and proliferating cell nuclear antigen （PCNA） in breast cancer tissue and their clinical significance. Methods The clinical pathology data of 156 patients with breast cancer managed with a routine surgical treatment, who had no chemotherapy or radiation therapy before operation, in Zaozhuang Municipal Hospital from January 2001 to December 2006 were retrospectively analyzed . Immunohistochemical SP method was used to determine the expressions of survivin and PCNA in the cancer tissues. Comparison between qualitative data was performed using linear trend test, Kappa test or Chi-square test according to different analytical purposes respectively. Logistic regression analysis was applied for the analysis of positive expressionrelated factors of survivin and PCNA. Results The positive expressions of survivin and PCNA protein in breast cancer tissues were not related with pathology feature and tumor size （P〉0. 050）, but were associated with tumor histological grade, clinic stage and the number of lymph node metastasis （P〈 0. 050）. The expressions of survivin and PCNA-positive cancer tissues were increased with the decrease of cancer tissue differentiation, and the increase in the number of lymph node metastasis and TNM staging. Logistic regression analysis showed that the histological grade of breast cancer was the main factor impacting the survivin and PCNA expression （P〈0. 050）. Survivin was positively related with PCNA （Kappa value, 0. 256; P〈0. 001）. Survivin and PCNA dual-positive patients had higher rates of recurrence and metastasis than survivin and PCNA dual-negative patients（χ^2= 6. 510, P = 0. 011）. Conclusion Detection of the expressions of survivin and PCNA can estimate the biological behavior and predict the prognosis for breast cancer.