尿路上皮癌Survivin的表达及其临床意义

The expression and clinical significance of Survivin in bladder transitional cell carcinoma

目的：探讨Survivin在尿路上皮肿瘤的表达情况及其与肿瘤分期、分级和复发的关系。方法：38例尿路上皮癌患者均有明确的病理学诊断。免疫组织化学染色方法按照试剂盒步骤进行，出现棕黄色胞质和（或）胞核染色区域为阳性，染色强度分为0、1、2、3分，计算表达指数，即染色强度评分×阳性细胞所占比例。结果：Survivin在尿路上皮癌表达的总阳性率为76．3％（29／38），8例正常膀胱粘膜均为Survivin阴性染色。癌组织Survivin的表达指数（1．131＋0．915）明显高于非癌组织（P〈0．001）。Survivin在T0／T1期肿瘤和T2-T4期肿瘤的表达指数分别为1．199±0．943和1．243±0．937，但统计学未见相关性（P=0．633）。Survivin在G1／G2级肿瘤和G，级肿瘤的表达指数分别为1．070±0．952和1．249±0．828，统计学亦未见相关性（P=0．569）。所有患者平均随访25个月，总复发率18．4％，其中Survivin阳性的肿瘤复发率20．7％（6／29），Survivin阴性的肿瘤复发率11．1％（1／9），但两者的差别并无显著性意义（Fisher=0．411）。结论：Survivin在尿路上皮癌组织中表达明显高于非癌组织，表明其在尿路上皮癌的发生、发展中占有重要作用；Survivin有可能成为尿路上皮癌的标志分子，具有潜在的临床诊断价值；Survivin表达与尿路上皮癌分期、分级可能无关，预测复发的价值尚不确定。

Objective ：To investigate the expression and clinical significance of Survivin in bladder transitional cell carcinoma （TCC）. Methods：A total of 38 cases of bladder TCC were studied. The method of immunohistochemistry was performed according to the protocol the producer supplied. The positive stained case was brown-yeUowishly stained. Calculate the Survivin stained index with the percentage of positive cells and its intensity score. Results ：29 cases （76.3%） were positively stained by Survivin antibody among 38 cases with bladder TCC. The overall expression levels in cancer were significantly higher when compared to non-neoplastic tissues （P 〈0. 001 ）. The Survivin stained index was 1. 199 ±0. 943 in T0/T1 tumors, and 1. 243 ±0. 937 in T2-4 tumors of bladder cancer. But there was no statistic significance （P=0. 633）. And also, the Survivin stained index was 1. 070 ±0. 952 in G1/G2 tumors, and 1. 249 ± 0. 828 in G3 tumors of bladder cancer. There was no statistic significance, too （P = 0. 569） . All the patients were followed up. Seven cases recurred during the follow-up period with a recurrent rate of 18.4%. There were 6 recurrent cases among 29 positive Survivin immunostaining group （20. 7% ） and 1 recurrent cases among 9 negative group （ 11.1% ） （ Fisher exact test,P =0. 411 ）. Conclusion：The overexpression of Survivin in bladder TCC tissue indicates it may play an important role during the development of bladder cancer. Although its expression has no statistic significance relationship with bladder cancer＇s stage or grade and relapse, Survivin may be an useful molecular marker and have the potential diagnostic value.