胰腺癌中livin、caspase-3的表达及其临床意义

Expression of livin and caspase-3 and their clinical significance in pancreatic carcinoma

目的探讨livin和caspase-3蛋白在胰腺癌中的表达及其与临床病理参数和预后的相关性及意义。方法应用高通量的组织芯片技术和免疫组化SP法检测88例无术前放化疗史的胰腺癌手术标本和11例非肿瘤性胰腺组织中livin和caspase-3蛋白的表达情况,运用Spearman秩相关分析两者之间的相关性,并对随访2个月～6年的54例病例作生存分析。结果88例胰腺癌组织中,livin的阳性表达率为76.1%(67/88),而caspase-3在非肿瘤性胰腺组织中的阳性表达率为90.9%(10/11),显著高于胰腺癌组织(40.9%,36/88),差异均有统计学意义(P<0.01);livin表达与患者性别、肿瘤大小、TNM分期及淋巴结转移相关(P<0.05),caspase-3表达与患者性别、组织学分化、TNM分期及淋巴结转移相关(P<0.01);经Spearman秩相关分析显示,livin和caspase-3在胰腺癌中有协同表达(P<0.01);在有随访结果的54例中,单因素COX分析显示,livin表达及淋巴结转移情况与预后相关(P<0.05),caspase-3表达及患者性别、年龄、部位、肿瘤大小、组织学分化程度、TNM分期与预后无关(P>0.05);多因素COX分析显示,只有livin表达具有独立的预后意义(P<0.05)。结论livin表达与胰腺癌临床病理参数及预后密切相关,可作为胰腺癌的独立预后指标,caspase-3可能参与细胞凋亡的调控和胰腺癌生物学进程。

Purpose To study the expression of livin and caspase-3 protein in pancreatic carcinoma and their correlation with clinicopathologic features and survivial time.Methods High-throughput tissue microarray technique and immunohistochemistry were used to detect the expression of livin and caspase-3 protein in 88 pancreatic carcinoma specimens without a history of chemo-radiation therapy and 11 non tumorous pancreatic tissues,and the relationship of these subjects was analyzed with Spearman rank correlation.Among these 88 cases,54 cases were followed-up for 2 months to 6 years,whom were used for the prognosis analysis.Results In the 88 cases, the positive rate of livin was 76.1%（67/88）;however,the positive expression of caspase-3 was 90.9%（10/11） in non-tumorous pancreatic tissue,which was much higher than that in the cancer（40.9%,36/88）,with statistically significant differences（P〈0.01）.There were significant relationships of livin protein expression with sex,TNM stage and lymph node metastasis（P〈0.05）; the expression of caspase-3 protein expression was significantly related to sex,histological grade,TNM stage and lymph node metastasis （P〈0.01）.Spearman rank correlation showed a significant correlation between livin and caspase-3 protein（P〈0.01）.In 54 cases with followed-up data,univariant analysis revealed that both of livin protein expression and lymph node metastasis were related to the survival rate（P〈0.05）,but caspase-3 protein expression,sex,age,tumor location,size,histological grade and TNM stage were unrelated to prognosis（P〉0.05）.Furthermore,COX stepwise proportional hazards analysis showed that only livin status retained independent significance in prospecting prognosis of pancreatic carcinoma.Conclusions The expression of livin is associated with clinicopathologic features and prognosis in pancreatic carcinoma.High expression of livin protein indicates poor prognosis,which could become an independent index for the evaluation of prognosis.caspase-3 protein may be involved in the regulation of apoptosis and the progression of pancreatic carcinoma.