survivin和COX-2在非小细胞肺癌中的表达及意义

Prognostic value of survivin and cyclooxygenase-2 expression in non-small cell lung cancer: a tissue microarray analysis

背景与目的应用组织芯片技术可以方便快捷地进行免疫组化染色。本研究的目的是探讨survivin和COX-2与非小细胞肺癌(NSCLC)患者临床病理特征和长期预后之间的关系。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SP法检测survivin和COX-2的表达。结果survivin胞质和胞核阳性表达率分别为94.3%和79.5%,COX-2阳性表达率为71.6%,而正常肺组织均为阴性,NSCLC中的survivin和COX-2表达明显高于正常肺组织(P<0.005)。survivin胞核阳性表达率在吸烟者中明显升高(P=0.002)。COX-2在女性、不吸烟者、腺癌和淋巴结转移阳性者中表达明显升高(P<0.05)。单因素分析显示COX-2表达与患者生存有密切关系(P=0.014),而survivin表达与生存未见明显关系。多因素分析显示survivin和COX-2均不是影响预后的独立危险因素。结论survivin检测可能有助于NSCLC的诊断;COX-2阳性表达者预后差,可能在预后判定中有重要作用。

Background and objective Tissue microarray provides a convenient shortcut for immunohis- tochemical staining. The aim of this study is to investigate the clinicopathologic and prognostic values of survivin and cyclooxygenase-2 （COX-2） expression level in patients with non-small cell lung cancer （NSCLC）. Methods Expression of survivin and COX-2 was detected in 88 cases of NSCLC and 5 cases of normal lung samples by immunohistochemical staining on tissue microarray sections. All cases were followed up for more than 5 years. Results Cytoplasmic and nuclear expression rate of survivin in NSCLC was 94.3% and 79.5%, respectively, and positive expression rate of COX-2 was 71.6%, however, neither survivin nor COX-2 expression was observed in normal lung tissues （P〈0. 005）. Nuclear expression of survivin was markedly higher in smokers than that in non-smokers （P=0. 002）. The positive expression of COX-2 was significantly related to gender, smoking, histologic subtype and lymph node metastasis （P〈0.05）. Univariate analysis showed that patients with positive expression of COX-2 had worse overall survival （P=0. 014）, however, survivin expression was not related to survival. Multivariate analysis showed that neither survivin nor COX-2 was independent prognostic factor for survival. Conclusion The results indicate that survivin highly expresses in NSCLC, so the ubiquitous expression makes it a potential novel parameter for diagnosis of NSCLC. Aberrant expression of COX-2 is related to worse overall survival, which may be useful to predict prognosis for NSCLC.