凋亡抑制蛋白Survivin和Bcl-2在非小细胞肺癌中的表达和意义

Prognostic Value of Survivin and Bcl-2 expression in Non-small Cell Lung Cancer:A Tissue Microarray Analysis

目的:探讨凋亡抑制蛋白Survivin和Bcl-2表达与非小细胞肺癌(NSCLC)预后之间的关系。方法:将88例NSCLC及5例正常肺组织标本制作成组织芯片,应用免疫组织化学S-P法检测Survivin和Bcl-2的表达,并与临床病理特征及长期生存进行比较分析。结果:Survivin胞浆和胞核阳性表达率分别为94.3%和79.5%,Bcl-2胞浆和胞核阳性表达率分别为54.5%和42.0%,而正常肺组织均为阴性。Survivin胞浆表达与年龄等临床参数无关,而Survivin胞核在吸烟者中表达升高(P=0.002)。Bcl-2胞浆表达在男性、吸烟者、鳞癌、淋巴结无转移者中升高(P<0.01),Bcl-2胞核表达在女性、不吸烟者、腺癌和肿瘤大小为T3和T4者中升高(P<0.05)。Survivin表达与NSCLC病人生存期无关。Bcl-2胞浆表达的病人生存期更长(P=0.005),而Bcl-2胞核表达的病人生存期更短(P=0.012)。多因素分析显示Survivin和Bcl-2不是影响NSCLC预后的独立危险因素。结论:Survivin检测可能有助于NSCLC的诊断,Bcl-2胞浆和胞核表达可能具有相反的预后意义。

Objective： To evaluate the prognostic value of survivin and Bcl-2 in patients with non-small cell lung cancer （NSCLC）. Methods： Expression of survivin and Bel-2 was accessed by immunohistochemical staining on tissue mieroarray sections, and the results were compared with relevant clinical and pathologic data. Results： Positive rate of cytoplasmic and nuclear survivin in NSCLC was 94.3% and 79.5%, respectively. Positive rate of cytoplasmic and nuclear Bcl-2 in NSCLC was 54.5% and 42.0%, respectively. Neither survivin nor Bcl-2 expression was observed in normal lung tissues. There was no correlation between cytoplasmic survivin expression and clinical characteristics, but nuclear survivin expression was higher in smokers （P=0.002）. Cytoplasmic Bcl-2 expression was significantly higher in groups with male, smokers, squamous cell carcinoma and no lymph node involvement （P〈0.01）, and nuclear Bcl-2 expression was significantly higher in groups with male, non-smokers, adenocarcinoma and tumor size with T3 and T4 （P〈0.05）. However, survivin expression was not related with survival. Patients with positive expression of nuclear Bcl-2 had worse overall survival （P=0.012）, whereas positive expression of cytoplasmic Bcl-2 predicted better overall survival （P=0.005）. Multivariate analysis using Cox regression modal showed that neither survivin nor Bcl-2 was the important independent prognostic factor for survival Conclusions： These results indicate that survivin highly expresses in NSCLC. so the ubiquitous expression makes it a polential noval parameter for diagnosis, and cytoplasmic and nuclear expression of Bcl-2 might possess completely opposite prognostic significance in patients with NSCLC.