食管鳞癌中Survivin和Nm23-h1表达及其联合检测的临床意义

目的：探讨Survivin与Nm23-h1基因在食管鳞状细胞癌、癌旁组织、正常组织中的表达情况及其联合检测与淋巴结转移的关系。方法：采用免疫组化sP法观察78例食管鳞癌手术切除标本，30例食管鳞癌切除标本断端（距肿瘤〉5cm）和食管鳞癌切除标本断端（距肿瘤〈2cm）30例的石蜡标本切片中Survivin和Nm23-h1的表达情况，分析其与临床病理特征的关系。结果：Survivin在食管鳞癌组织，癌旁组织，正常组织的阳性表达率分别为70．51％，20．0％，6．67％，有显著性差异（P=0．001）。Nm23-h1在食管鳞癌组织，癌旁组织，正常组织的阳性表达率分别为60．26％，80．00％，96．67％，有显著性差异。（P=0．001）。Survivin表达与肿瘤分化程度、TNM分期、淋巴结转移相关（P〈0．05）。Nm23-h1表达与患者的TNM分期、淋巴结转移相关（P〈0．05）。Survivin阳性率与淋巴结转移呈正相关（P=0．008），nm23-h1阳性率与淋巴结转移呈负相关（P=0．001）。Survivin与nm23-h1呈低度负相关（P=0．001），在促进肿瘤的进展和转移过程中起联合作用。结论：Survivin蛋白的抑制凋亡作用和nm23蛋白的抑制转移作用可能在食管鳞癌的发生、发展过程中起重要作用，联合检测是判断食管鳞癌患者淋巴结转移倾向及预后的重要指标。

The expressions of survivin and nm23 - h1 genes in esophageal squamous cell carcinoma and the clinical significance of the combined detection

Objective： To understand the relationship between the expression of Survivin, nm25 -h1 gene and lymph node metastasis in esophageal squamous cell carcinoma（ESCC）. Methods：The expression of survivin, nm23 - h1 protein was examined in 78 ESCC patients using immunohistochimical S - P method. Results ： Survivin protein positive expression rates were 70. 51% in ESCC 20. 0% in adjacent tissues and 6. 67% in normal tissues, （ P = 0. 001 ）. Nm23 - h1 protein positive expression rates were 60.26% in ESCC, 80.00% in adjacent tissues and 96.67% in normal tissues, （ P = 0.001 ）. Survivin protein expression was related with cell differentiation, TNM staging and LNM （ P 〈 0.05）. Nm23 - h1 protein expression was related with TNM staging and LNM （ P 〈 0.05 ）. Survivin protein positive expression had positive correlation with the lymph nodes metastasis （ P = 0.008 ）, nm23 - h1 protein expression had negative correlation with the LNM（P =0.001 ）. The negative correlation was found between survivin and nm23 -h1 expression（ P = 0.001 ）. Conclusion：The anti - apoptosis effect of Survivin protein and the anti - metastasis effect of nm23 - h1 protein may be important in the occurrence and advancement of ESCC, suggesting that it may be a useful markers of predicting of LNM and poor prognosis in the patient with ESCC.