survivin基因与子宫颈癌发生及预后的关系

Relationship of survivin to occurrence and prognosis of cervical cancer

目的探讨凋亡抑制基因survivin与子宫颈癌发生及预后的关系。研究survivin与子宫颈癌患者临床病理特点之间的关系。方法选取本院1993～2002年间收治的83例子宫颈鳞癌及1994～2004年间随机抽取的子宫颈CIN-Ⅰ25例、CIN-Ⅱ32例、CIN-Ⅲ48例,正常子宫颈30例作为对照。用免疫组化的方法对其survivin基因表达进行检测。比较survivin在正常子宫颈、宫颈CIN及子宫颈癌中表达的差异,分析survivin与子宫颈癌患者临床病理特点的关系;用Cox回归分析方法判定子宫颈癌的预后影响因素,分析survivin与子宫颈癌患者预后的关系。结果正常子宫颈survivin基因表达均为阴性。survivin基因表达随子宫颈病变的发展逐渐升高,差异有统计学意义(P<0.05)。与子宫颈癌患者的淋巴转移显著相关(P<0.05)。与子宫颈癌患者的年龄、分期、病理分级无显著关系。结论survivin基因在从宫颈癌前病变向子宫颈癌演变的过程中有重要作用;与子宫颈癌患者的淋巴转移显著相关;而子宫颈癌的分期及survivin基因表达为独立预后影响因素之一。

Objective To explore the relationship of the survivin gene expression to the occurrence and the prognoisis of cervical cancer,and to study the relationship of the survivin gene expression to clinicopathological characteristics of the cervical cancer. Methods Immunohistochemical S-P method was used to determine the survivin gene expression in 83 squamous carcinomas of the uterine cervix tissues from 1993 to 2002,105 CIN tissues and 30 normal cervix tissues as control from 1994 to 2004 in Chongqing Cancer Hospital. To compare the difference of the survivin expression between the cervical cancer and CIN and normal cervical tis- sue and to analyze the relationship between the survivin gene expression and the clinicopathological characteristics. The multivariate Cox proportional hazard regression model was used to determine the prognostic factors of squamous carcinoma of the uterine cervix and analyze the relationship between the survivin gene expression and the prognosis of the patients with squamous carcinoma of the uterine cervix. Results The survivin gene expression of 30 normal cervix tissues was negative. Survivin expression tended to increase along with tumor progression（P〈0.05）. A significant association was seen between the survivin expression and the lymph node metastasis（P〈0.05）. It was no statistically significant correlation between survivin expression in the tumour and the patients＇ age, stage and grade. Conclusion survivin seems to act an important role in progression of CIN and cervical cancer. The survivin expression and the lymph node metastasis have significant association. The survivin expression and the stage of the cervical cancer are independent prognostic factors in the cervical cancer.