食管癌组织芯片COX-2和survivin表达及其与预后的关系

Expression of COX-2 and survivin in Esophageal Carcinoma and Relationship with Prognosis

目的研究食管癌组织中COX-2和survivin蛋白的表达,及其预后意义。方法采用免疫组化EnVision法和组织芯片技术,检测手术切除的56例食管癌组织中COX-2和survivin蛋白的表达状况,通过Cox比例风险模型进行多因素分析,探讨与食管癌患者预后的关系。结果COX-2和survivin在食管癌组织阳性表达率分别为69.6%和71.4%。COX-2和survivin表达呈正相关(r=0.614,P=0.002),且与肿瘤浸润深度、淋巴结转移及TNM分期密切相关。COX-2表达阳性患者的中位生存时间明显短于阴性患者(25.13月vs.69.33月,P=0.0001),survivin表达阳性患者的中位生存时间明显短于阴性患者(25.23月vs.69.32月,P=0.0000)。Cox多因素分析表明,COX-2和survivin蛋白阳性表达为影响食管癌患者预后的独立因素。结论COX-2和survivin在食管癌中呈过度表达,且呈正相关,二者在肿瘤中可能发挥协调作用。COX-2和survivin高表达预示食管癌的不良预后,可以作为影响食管癌患者预后的独立因素。

Objective To study the expression of COX-2 and survivin in esophageal squamous cell carcinoma （ESCC）, and their prognostic significance. Methods The expression of COX-2 and survivin in 56 cases of ESCC sections was detected by immunohistochemistry with Envision non-biotin detection system and tissue micro-array （TMA）. Cox proportional hazard regression model was performed to study the relationship between their expression and patients＇ prognosis. Results The positive rate of COX-2 and survivin was 69. 6% （39/56） and 71.4% （40/56）, respectively, COX-2 expression was positive correlation with survivin expression （P = 0. 002, r = 0. 614）. The both COX-2 and survivin were correlated with tumor infiltration depth, lymph node metastasis and TNM staging. The median survival of COX-2 or survivin positive group was significant shorter than that of COX-2 （25.13 vs. 69. 33, P = 0. 0001） or survivin negative group （25.23 vs. 69. 32,P = 0. 0000）, respectively, Cox regression multivariate survival analysis indicated the expression of COX-2 and survivin proteins were the independent prognostic factors for ESCC patients. Conclusion This study showed that the expression of COX-2 and survivin was upregulated in ESCC. COX-2 expression was positive correlation with survivin expression, which indicated that both proteins might play a synergetic role during ESCC progression. The over-expression of COX-2 and survivin proteins was the independent prognostic factors for ESCC patients.