结直肠癌组织中Survivin表达的临床病理学意义

目的 :研究凋亡抑制蛋白Survivin在结直肠癌组织中的表达及其临床病理学意义。方法 :采用SP法检测 10 6例结直肠癌组织中Sur vivin的表达 ,分析Survivin表达与各临床病理因素的关系 ;应用Kaplan Meier法分析Survivin表达对结直肠癌生存率的影响。结果 :Survivin在结直肠癌组织中的表达率为 64 2 % ( 68/10 6) ,癌旁形态学正常的结直肠黏膜未见Survivin表达 ;Survivin在中、高分化结直肠癌表达阳性率 72 4% ( 63 /87) ,明显高于低分化结直肠癌( 2 6 3 % ,5 /19) ,P <0 0 5。Survivin表达与患者性别、肿瘤位置、浸润深度、淋巴结转移、远处转移以及Duke’s分期差异无统计学意义 ,P >0 0 5。Sur vivin阳性表达的结直肠癌患者 5年生存率为 42 6% ( 2 9/68) ,Survivin阴性表达患者为 68 4% ( 2 6/3 8) ,差异有统计学意义 ,P <0 0 5。结论 :凋亡抑制蛋白Survivin在结直肠癌组织中存在高表达 ,与结直肠癌预后有关 ,可作为判断结直肠癌预后的辅助指标。

Expression of Survivin in colorectal cancer and its clinical significance

OBJECTIVE: To study the expression of inhibitor apoptosis protein of Survivin in colorectal carcinoma and its correlation with clinicopathological feature and prognosis.METHODS:Immunohistochemical staining of Survivin was performed by the standard streptavidin-peroxidase (SP) technique for the paraffin sections of 106 colorectal cancers.The relationship between the Survivin expression and the clinicopathological parameters was analyzed. Kaplan-Meier method was used to investigate the correlation between Survivin expression and survival rate of the patients for whom long term follow up data were available. RESULTS:The positive rate of Survivin in colorectal carcinoma was 64.2%(68/106),no expression of Survivin was detected in normal colorectal tissues. Significant relationship was found between Survivin expression and the histological differentiation grade of colorectal carcinoma. The positive rate of Survivin in middle to well differentiated colorectal carcinoma(72.4%,63/87)was significantly higher than that in poorly differentiated colorectal carcinoma(26.3%,5/19),P<0.05. However, there was no correlation between Survivin expression and other clinicopathological parameters such as sex, tumor site, tumor depth, lymph node metastasis, distant metastasis, and Dukes' stage.The 5-year survival rate of patients with Survivin-positive tumors was significantly lower than that of patients with Survivin-negative tumors (42.6% vs 68.4%, P<0.05, log-rank test).CONCLUSIONS: A high expression of inhibitor apoptosis protein of Survivin is found in colorectal carcinoma.The expression of Survivin is correlated with prognosis. It may be a significant prognostic parameter of worse outcome in colorectal carcinoma.