生存素在结肠癌患者中的表达及临床意义的研究

Expression of survivin and its clinical significance in colon cancer

目的:研究抗凋亡蛋白生存素(survivin)在结肠癌患者的癌组织和外周血中的表达,以评估其临床应用价值。方法:用免疫组化技术检测28例结肠癌患者组织中生存素的表达,用逆转录-实时定量PCR技术检测了28例结肠癌患者癌组织和13例非癌性结肠病变组织和30名正常人外周血中生存素的表达。结果:结肠癌组织中生存素蛋白的表达率为96.4%。生存素基因在结肠癌组织中的表达率为100%,mRNA的平均拷贝数为1.22×105/mg;在非癌性结肠病变组织中的表达率为46%,mRNA的平均拷贝数为1.59×103/mg,两者间mRNA的表达率和表达量差异均有显著性(P<0.01;P<0.05)。81.5%的结肠癌患者外周血中检测到生存素转录本,30名正常人外周血中均未检测到。结论:生存素的表达与结肠癌密切相关,患者外周血中检测到生存素基因的转录本提示患者外周血循环中可能存在从癌组织脱落的肿瘤细胞,因此在外周血中检测生存素的转录本可能是观察肿瘤复发、判断疾病预后的良好指标。

Objective To detect the survivin expression in colon cancer and evaluate its clinical application. Methods The immunohistochemistry technique was used to detect the expression of survivin protein in the colon cance-rous tissues of 28 cases; while the survivin mRNA expression was detected by real-time RT-PCR. Pre-operative peripheral blood samples of those patients were collected for quantifying the survivin mRNA. Thirteen cases of non-cancerous colon lesion tissue samples and the peripheral blood samples of 30 healthy volunteers were used as controls. Results The expression of the survivin protein was detectable in 96.4% of the colon cancerous tissues. The expression of the survivin mRNA was detectable in all of them with an average copy number of 1.22×105/mg and found in 46% of the non-cancerous colon lesion tissues with an average copy number of 1.59×103/mg. There was significant difference in the survivin expression rate and the mRNA quantity between the patient samples and the controls (P<0.01 and P<0.05, respectively). The survivin mRNA expression was also observed in 81.5% of the peripheral blood in the patients with colon cancer, but none in the healthy controls. Conclusions The expression of survivin is closely correlated with colon cancer. The existance of survivin in the peripheral blood implies the exfoliation of the tumor cells from the cancerous tissues. Therefore, the quantification of survivin mRNA in the peripheral blood in the patients with colon cancer may be a useful marker for evaluating tumor recurrence and prognosis.