Survivin在结直肠癌中的表达及其临床意义

目的:探讨结直肠癌组织中凋亡抑制因子Survivin的表达及其与各临床病理因素的关系,评价Survivin在结直肠癌预后判断中的价值。方法:应用组织芯片结合免疫组织化学SABC法,检测126例结直肠癌组织中Survivin的表达情况,分析Survivin与各临床病理因素及预后之间的关系。结果:根据免疫组化染色强度和分级结果,所有病例被分为Survivin高表达组和低表达组。其中高表达组有26例(26/126,20·6%),低表达组有100例(100/126,79·4%)。Survivin在结直肠癌中表达情况与年龄、性别、肿瘤大小、肿瘤部位、组织学类型、浸润深度、淋巴是否转移和Dukes分期均无显著相关。然而,高表达的Survivin与肿瘤复发、特别是血行转移显著相关,P<0·05。Survivin高表达组和低表达组的生存率用Kaplan-Meier方法评估,并用log-rank test进行比较,两组之间生存率差异具有统计学意义,P<0·05。多因素分析结果显示,在潜在的预后因素中(年龄、性别、肿瘤大小、肿瘤部位、组织学类型、淋巴是否转移和Dukes分期、Survivin表达),Survivin表达和Dukes分期被认为是结直肠癌根治术后独立预后因素。结论:Survivin的表达与结直肠癌的术后复发相关:结直肠癌术后复发率在Survivin高表达组明显高于Survivin低表达组,是与预后相关的独立危险因子。应用组织芯片高效检测临床组织样本具有快速、方便、经济、准确的优点。

Expression and clinical significance of survivin protein in colorectal carcinoma

OBJECTIVE:To investigate the relationship between the expression of survivin and the clinicopathological parameters in colorectal carcinoma, and evaluate its significance in predicting the prognosis. METHODS: Tissue chip and immunohistochemistry methods by SABC were used to, examine survivin expression in 126 patients with advanced human colorectal cancer, and the relationship between survivin and clinicopathological features and prognosis was retrospectively analysed. RESULTS: The patients were divided into low-and high-survivin groups according to the grade and extent of survivin expression. high-survivin expression was observed in 26(20.6%) cases, low-survivin expression was observed in 100(79.4%) cases. There was no significant correlation between survivin expression and age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis and Dukes classification. However, high survivin expression was strongly correlated with tumor recurrence, especially haematogenous metastasis,P<0.05. The survival rate without tumor recurrence for high-and low-survivin groups was assessed by the Kaplan-Meier method and compared by log-rank test. The disease-free survival rate was significantly different between the two groups,P<0.05. The multivariate analysis for all patients showed that, among the 8 prognostic factors (age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis and Dukes stage, and survivin expression), Dukes stage and survivin expression was recognized as the independent significant factor related to disease-free survival. CONCLUSIONS: The expression of survivin is strongly correlated with tumor recurrence in colorectal cancer, especially haematogenous metastasis. The recurrence rate is significant higher in the group of high-Survivin expression than in the group of low-survivin erpression. Survivin is the independent dangerous factor related to prognosis. Tissue microarray reveals characteristics of rapid, convenience, economy and accuracy in large-scale application.