非小细胞肺癌中survivin上调与p53和Bcl-2的临床病理相关性

Upregualtion of survivin in non-small cell lung cancer and its clinicopathological correlation with p53 and Bcl-2

目的:通过回顾性分析87例非小细胞肺癌(NSCLC)的临床病理资料,探索survivin、p53和Bcl-2的临床病理相关性以及联合检测提示NSCLC预后的可能性。方法:采用免疫组化SP法检测NSCLC中survivin、p53和Bcl-2的表达。用Spearman等级相关系数检验其与NSCLC发生的相关性。结果:NSCLC组织的survivin蛋白阳性表达率为55.2%(48/87),阳性表达主要定位于NSCLC细胞质中。不同分期的NSCLC在survivin阳性表达率方面存在显著差异:III和IV期(中晚期)病例阳性率为71.1%(32/45),而I和II期(早中期)阳性率则为38.1%(16/42,P<0.01)。不同原发肿瘤分期病例未显示出差异性survivin表达;而survivin表达则具有显著N分期相关性,无淋巴结转移(N0)病例的阳性率为43.5%(27/62),有淋巴结转移(N1和N2)病例则为84.0%(21/25,P<0.01)。Survivin在鳞癌和腺癌中表达率分别为76.0%(38/50)和27.0%(10/37),其表达在两种病理类型间存在统计学差异(P<0.01)。NSCLC组织的p53蛋白阳性表达率为64.6%(56/87),阳性表达产物主要定位于NSCLC细胞质中。有淋巴结转移(N1和N2)病例阳性率(84.0%,21/25)显著高于无淋巴结转移病例(54.8%)(34/62,P<0.01)。而且p53表达同时还具有组织类型相关性,鳞癌病例阳性率(76.0%,38/50)显著高于腺癌病例(27.0%)(10/37,P<0.01)。NSCLC组织的Bcl-2蛋白阳性表达率为56.3%(49/87),阳性表达产物定位于NSCLC细胞质和细胞核中。有淋巴结转移(N1-2)病例阳性率(48.0%,12/25)明显高于无淋巴结转移病例(22.6%)(14/62,P<0.01)。结论:Survivin上调显示出与NSCLC的临床病理相关性,同时survivin与p53和Bcl-2在NSCLC中也具有一定的临床病理相关性。

AIM： To retrospectively analyze the clinicopathological data of 87 non-small cell lung cancer （NSCLC） specimens and explore the clinicopathological correlation of survivin with pS3 and Bcl-2 and the applicability of combined detection for NSCLC prognosis. METHODS： Survivin, p53 and bcl-2 expression levels were examined in 87 NSCLC specimens using streptavidin-peroxidase （SP） immunohistochemistry. The correlation with NSCLC was analyzed with Spearman rank correlation test. RESULTS： Survivin was positive in 55.2% （48/87） of NSCLC specimens, which was mainly located in cytoplasms and cell-specific. NSCLC at various stages showed significant difference in the positivity of survivin： at stage III and IV （mid and late stage） was 71.1% （32/45） while at stage I and II （early and mid stage） was 38.1% （16/42, P〈0.0]）. Primary tumor with various staging showed no differential expressions of survivin; expression of survivin was significantly correlated with N staging whereby the positivity of specimens without lymph nodal involvement （NO） was 43..5% （27/62） and that for those with lymph nodal involvement （N1-2） was 84. 0% （21/2.5, P 〈 0. 01 ）. Survivin was detected in 76. 0% （38/50） squamous cell carcinoma and 27.0% （10/37） of adenocarcinoma in a significantly different manner （ P 〈 0.01 ）. p53 was positive in 64.6% （56/87） of NSCLC specimens, which was mainly located in cytoplasms and cell-specific. The positivity of specimens with lymph nodal involvement （N1-2） （84.0%, 21/25） was significantly higher than that for those without lymph nodal involvement （N0） （54.8%） （34/62, P 〈 0.01 ）. Moreover, p53 expression was tissuespecific whereby the positivity with squamous cell carcinoma （76.0%, 38/50） was significantly higher than that with adenocarcinoma （27.0%）, （ 10/37, P 〈 0.01 ）. Bcl-2 was positive in 56.3% （49/87） of NSCLC specimens, which was mainly located in cytoplasms and nuclei and cell-specific. The positivity of specimens with lymph nodal involvement （N1-2） （48.0%, 12/25） was significantly higher than that for those without lymph nodal involvement （NO） （22.6%） （14/62, P 〈 0.01）. CONCLUSION： Upregualtion of survivin represented its clinico-pathological association with NSCLC and meanwhile substantial correlation is confirmed between survivin, p53 and bcl-2.