survivin 和增殖细胞核抗原(PCNA)在鼻腔鼻窦恶性黑色素瘤(SNM)中的表达及其临床意义

 目的  探讨survivin和增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)在鼻腔鼻窦恶性黑色素瘤(sinonasal melanoma,SNM)中的表达及其与患者临床病理特征及预后的关系。方法  选取2004年3月至2011年8月在本院治疗的42例SNM患者的石蜡标本。采用免疫组织化学方法检测survivin和PCNA在SNM 组织中的表达情况,分析survivin 和PCNA表达水平与患者临床病理特征及预后的关系。结果  survivin 和PCNA 表达水平与性别、年龄、肿瘤部位、淋巴转移部位及个数无明显相关性(P>0.05);肿瘤组织中survivin蛋白表达率为73.8% (31/42),PCNA蛋白表达率为100% (42/42);单因素分析结果显示,survivin 高表达患者无瘤生存期(disease free survival,DFS)及总生存期(overall survival,OS)明显低于survivin 低表达者(P<0.05);患者临床分期及survivin表达水平与患者预后相关(P<0.05),差异有统计学意义;多因素分析结果显示临床分期和survivin表达水平是SNM患者的独立不良预后因素。PCNA表达与SNM患者DFS、OS无明显统计学差异。结论  survivin表达水平与SNM患者预后相关,可作为评估SNM患者预后的一项重要指标。

Expressions and significances of survivin and proliferating cell nuclear antigen (PCNA) in sinonasal melanoma (SNM)

Objective  To explore the expressions of survivin and proliferating cell nuclear antigen (PCNA) in sinonasal melanoma (SNM) and their predictive values for recurrence and metastasis.Methods  We collected 42 paraffin-embedded samples of SNM treated in our hospital from Mar.,2004 to Aug.,2011.Survivin and PCNA were detected in the tissues of SNM by immunohistochemistry.The differences of survivin and PCNA expressions in the tissues were evaluated and matched with clinicopathological parameters and survival,respectively.Results  Both survivin and PCNA expressions were not significantly associated with patients′ clinicopathological features (P>0.05).Expression of survivin was detected in 31 patients (73.8%).Expression of PCNA was detected in 42 patients (100%).Univariate analysis indicated that disease free survival (DFS) and overall survival (OS) of patients with survivin high expression were lower than those with survivin low expression (P<0.05).Positive expression of survivin and clinical stage were the prognosis factors for patients with sinonasal melanoma (P<0.05).Multivariate analysis indicated that clinical stage and expression of survivin were independent prognosis factors.Expression of PCNA was not significantly associated with DFS and OS of patients.Conclusions  There was correlation between the expression of survivin and prognostic impact in patients with SNM.It might be an important factor in valuing the prognosis of patients with SNM.