生存素在结肠癌中的表达及其临床病理意义

Survivin and its association with clinicopathological features of colon cancer

目的探讨Survivin蛋白在结肠癌中的表达及其与肿瘤分化程度、浸润深度、淋巴结转移、Dukes分期等各临床病理参数之间的关系。方法应用免疫组织化学技术,检测43例结肠癌组织中Survivin蛋白的表达,并与同期15例结肠腺瘤与10例正常癌旁组织作对照。结果结肠癌组织中Survivin的阳性表达率为62.79%,显著高于腺瘤组和正常癌旁黏膜组,差异有统计学意义(χ2分别=10.88、12.80,P均<0.05);Survivin的阳性表达与肿瘤的浸润深度、脉管侵犯及淋巴结转移呈正相关(χ2分别=4.46、7.57、6.66,P均<0.05),与Dukes分期有关(χ2=5.59,P<0.05),与患者性别、年龄、肿瘤大小、分化程度无明显关系。Survivin表达阴性和阳性患者的5年生存率比较,差异有统计学意义(χ2=5.08,P<0.05)。结论Survivin在结肠癌组织中呈高表达,并参与结肠癌的侵袭与进展,可能是反映结肠癌生物学行为及判断其预后的重要生物学指标之一。

Objective To explore the expression patterns of survivin in tissue specimens of primary colon cancers and the association between the surviving expression and pathological characteristics of colon cancer. Methods Formalin-fixed paraffin-embedded samples from 43 colon cancer, 15 adenoma and 10 non-cancer mueosa were immunostained using polyelonal survivin. The degree of immunostaining was recorded according to the percentages of staining and distributions within the cytoplasm and nucleus. Results 62.79% of cancer samples were positive for surviving protein, while normal colon tissue was immunonegative. Statistical analysis revealed that survivin expression was correlated with invasive depth, vessel infiltration, lymph node metastasis （X^2=4.46, 7.57,6.66, P〈0.05）and Dukes stage （x^2=5.59, P〈0.05）, but independent of gender, age, tumor size, and differentiation. The survival time had significant difference between survivin expression positive and negative patients （X^2=5.08,P〈0.05）.Conclusions Survivin is frequently overexpressed in primary colon carcinoma and could both be a useful diagnostic marker and a favorable prognostic indicator for colon cancer patients.