Survivin在喉鳞癌组织中表达及其与临床相关因素的关系

Survivin Expression in Laryngeal Squamous Cell Carcinoma and its Relationship with Clinical Factors

背景与目的:survivin是凋亡抑制蛋白家族的一个新成员。survivin在大多数肿瘤中有表达,但在成人终末分化组织中一般不表达或低表达。本研究检测喉鳞癌组织中survivin的表达,分析其与喉鳞癌患者年龄、性别、临床分期、T分期、N分期、喉癌分型、病理分化、复发以评价其与预后的相关性。方法:收集1997年1月～1998年12月我院收治的81例喉鳞癌患者的临床资料和石蜡块,制作组织芯片,用链霉素亲生物素-过氧化物酶法(SP)检测肿瘤组织和周围正常喉粘膜的survivin表达;统计学分析采用SPSS10.0软件,采用Kaplan-Meier法进行生存分析并进行log-rank检验,因素间的相关关系采用χ2检验,多因素分析采用Cox模型。结果:本组喉鳞癌患者总的5年生存率约58.33%;survivin在喉鳞癌和正常喉组织中的表达阳性率分别为50.62%,0%,(P<0.05);survivin表达阳性组(5年生存率22.06%;复发率43.90%)较阴性组(5年生存率92.33%;复发率12.50%)预后差(P<0.05);单因素分析显示:临床分期、T分期、N分期、病理分级、复发、survivin阳性表达是影响患者预后的主要因素(P<0.05);χ2检验显示:survivin表达与临床分期、T分期、N分期、病理分化、复发相关(P<0.05);多因素分析显示:survivin表达、临床分期、复发是喉癌独立的预后因素。结论:survivin表达?

BACKGROUND &OBJECTIVE: Survivin, a new described member of the f am ily of apoptosis inhibitory proteins (IAP), is undetectable in normal tissue of adults, but abundantly expressed in a variety of human malignancies. This study was designed to examine the expression of Survivin in laryngeal squamous cell ca rcinoma, analyze the relationships between the expression of Survivin and progno stic factors including age, gender, clinical stage, T stage, N stage, classifica tion, histology and recurrence, to investigate its significance on prognosis. ME THODS:Clinical information and paraffin-embedded tumor samples of 81 cases lary ngeal squamous cell carcinoma(LSCC) patients, who were treated at Cancer Center of Sun Yat-sen University between 1997 and 1998, were collected. Tissue chip wa s made, and SP method was performed to analyze Survivin expression in tumor tiss ue and adjacent normal laryngeal mucosa. SPSS 10.0 software was used. Kaplan-Me ier method was used for survival analysis, and log-rank test was used for data analysis; multivariate analysis was carried out using Cox proportional hazard mo del. RESULTS: The overall 5-year survival rate for patients with laryngeal squa mous cell carcinoma in this study was 58.33%. The over-expression rate of Surv ivin in tumor tissue and adjacent normal laryngeal tissue were 50.62%, 0%, res pectively (P< 0.05). The positive Survivin expression group(5-year overall s urivial rate: 22.06%)had a worse prognosis than that of negative group (5-yea r overall survival rate: 92.33%)(P< 0.05). The univariate analysis showed tha t clinical stage, T stage, N stage, histology grade, recurrence, and Survivin ex pression were the most important prognostic factors (P< 0.05). The clinical stage, T stage, N stage, histology grade and recurrence(P< 0.05); Multivariate analys is results showed that clinical stage, survivin expression, and recurrence were independent prognosis factors on survival in LSCC patients. CONCLUSIONS: The exp ression of Survivin is an important biological factor affecting the prognosis; T issue chip method can be simply and efficiently used in large scale of retrospec tive study in laryngeal squamous cell carcinoma.