凋亡抑制蛋白Livin在上尿路移行细胞癌中的表达及其与预后的关系

目的检测Livin蛋白在人正常膀胱组织及上尿路移行细胞癌组织中的表达情况,并分析其表达与肿瘤临床分期、病理分级及肿瘤复发之间的关系。方法采用免疫组织化学法检测12例正常上尿路上皮组织切片及58例上尿路移行细胞癌组织标本及中Livin基因的表达情况。结果 Livin蛋白在正常上尿路上皮组织中无表达,而在移行细胞癌组织中高表达,阳性表达率为60.3%。Livin蛋白在不同性别、年龄及是否伴有淋巴结转移患者中的表达差异无统计学意义(P>0.05),而不同分期及分级的组间表达差异具有统计学意义(P<0.05)。随访9-45个月(平均29.3个月),肿瘤患者中共有27例出现局部或膀胱复发,总复发率为46.6%,其中Livin表达阴性组3年估计无瘤复发生存率为49.5%,而Livin表达阳性患者3年估计无瘤复发生存率为30.1%,二者之间差异显著(P=0.04)。结论 Livin在正常上尿路移行上皮组织中不表达,在上尿路移行细胞癌组织中高表达,Livin的表达与上尿路移行细胞癌分期、分级密切相关,与肿瘤复发密切相关。

The expression of Livin gene in upper urinary tract transitional cell carcinoma and its relation to the tumor relapse

Objective To assess the expression of Livin gene,a new member of the inhibitor of apoptosis protein family,in upper urinary tract transitional cell carcinoma（UTCC） and to indentified the relationship between tumor stage,tumor grade and relapse with its expression.Methods Immunohistochemical staining for livin was performed using paraffin-embedded tissues from 58 cases of UTCC and 12 normal tissue of upper urinary tract.Disease-specific survival of patients was assessed,the differences between the immunohistologically livin-positive and livin-negative groups was compared with recurrence-free survival using the Kaplan-Meier method and log-rank test.Results Of the 58 UTCC specimens,35（60.3%） showed positive staining of Livin immunohistochemically.There is no expression in normal upper urinary tract tissues.The expression of Livin gene were statistically similar in different age,sex and lymph node metastasis status groups（P0.05）.Howerver,the positive expression rate of Livin gene of different tumor grade and stage groups showed a statistically difference（P0.05）.The mean follow up was 29.3 months,the over all recurrence rate was 46.6%.For positive expression group,the 3-year estimate recurrence free survival rate was 30.1%,and 49.5% for the negtive expression group,the difference was significant（P0.05）.Conclusion Livin gene can be detected in UTCC tissues,and its expression is correlated with the tumor stage,grade and tumor relapse,it may be recognized as a biomarker of UTCC.