胰腺癌中S100 A4和Survivin的表达及其与预后关系的研究

Correlation of both S100 A4 and Survivin expressions with the prognosis of pancreatic cancer patients

目的探讨钙离子结合蛋白S100 A4和Survivin在胰腺癌中的表达与临床病理因素及预后的关系。方法采用免疫组化二步法检测63例手术切除的原发性胰腺癌组织及11例癌旁非肿瘤胰腺组织中S100 A4和Survivin的表达情况,比较S100 A4、Survivin蛋白表达与临床病理因素的关系及对患者预后的影响。结果 (1)63例标本中S100 A4和Survivin阳性率分别为74.6%(47/63)、69.8%(44/63),而癌旁非肿瘤胰腺组织中均未见二者表达。(2)S100 A4、Survivin蛋白的表达存在显著相关性(P=0.000,r=0.570)。(3)S100 A4表达与肿瘤的TNM分期(P=0.002)、淋巴结转移(P=0.002)及远处转移(P=0.007)显著相关,Survivin表达与肿瘤的TNM分期(P=0.034)、淋巴结转移(P=0.020)及分化程度(P=0.000)显著相关。(4)S100 A4阴性/Survivin阴性患者(11例)中位生存时间(>36个月)明显大于S100 A4阳性/Survivin阳性组患者(37例)中位生存时间(9个月)(Log-rank检验,χ2=42.171,P=0.000)。(5)分化程度(P=0.002)、TNM分期(P=0.002)、S100 A4过表达(P=0.001)及Survivin过表达(P=0.024)为影响胰腺癌预后的独立因素。结论 S100 A4和Sur-vivin的高表达与胰腺癌的临床病理参数密切相关,且两者之间的表达强度具有等级相关性,二者在胰腺癌的生长浸润过程中可能有协同作用,其高表达提示患者预后不良。联合检测二者表达可预测胰腺癌发生转移的危险性及患者预后情况的参考。

Objective To study the expression of calcium-binding protein S100A4 and Survivin in pancreatic cancer and their correlation with clinicopathological parameters and prognosis of pancreatic cancer patients.Methods The expressions of S100A4 and Survivin were examined in 63 surgical specimens of primary pancreatic carcinoma and in 11 patients with the pancreatic tissue of noncarcinoma with immunohistochemistry PV method,Correlation of these expressions with clinicopathological parameters and prognosis of pancreatic cancer was analyzed.Results (1)47 of 63(74.6%)specimens of primary pancreatic cancer were positive for S100A4 and 44 of 63(69.8%)pancreatic cancer specimens showed positive expressions of Survivin according to immunohistochemistry detection and there was no expression of S100A4 or Survivin in adjacent normal pancreatic tissues.(2)The positive expressions of S100A4 and Survivin were significantly correlated with pancreatic cancer (P=0.000,r=0.570).(3)The expressions of S100A4 significantly correlated with TNM stages(P=0.002),lymph node metastasis(P=0.002)and distant metastasis(P=0.007).The expression of Survivin had a significant correlation with TNM stages(P= 0.034),lymph node metastasis (P=0.020)and differentiation(P=0.000).(4)The median survival(>36 months) of 11 patients with S100A4(-)/Survivin (-) was significantly longer than the median survival (9 months) of 37 patients with S100A4(+)/Survivin (+) (χ2=42.171,P=0.000).(5)The differentiation (P=0.002),TNM stages(P=0.002),S100A4(+)expression (P=0.001) and Survivin (+)expression(P=0.024)were independent prognostic factors for pancreatic cancer.Conclusions This study shows that the over-expressions of S100A4 and Survivin proteins are related with clinicopathological parameters of pancreatic cancer patients,S100A4 expression is positive correlation with Survivin expression,they may have a synergistic function in the process of growth and invasion in pancreatic cancer,S100A4 and Survivin maybe poor prognostic predictors for pancreatic cancer patients.They may be potential indicators of metastasis and predictors for prognosis of pancreatic carcinoma.