肝细胞癌survivin表达与临床相关性

Clinical signif icance of survivin expression in hepatocellular carcinoma

目的:探讨survivin在肝细胞癌(HCC)组织中的表达及其与临床病理资料的关系.方法:采用免疫组织化学及半定量RT-PCR检测76例HCC组织中survivin表达情况,分析其与临床病理资料的关系;应用Kaplan-Meier法及多变量Cox比例风险模型,分析survivin表达与预后的关系.结果:76例HCC组织中survivin阳性表达53例,表达率69.74%;肝癌组织survivinmRNA表达明显高于癌旁组织(0.782±0.284vs0.251±0.064,P<0.01);survivin阳性表达与HBsAg阳性、Edmondson等级、门静脉癌栓及肿瘤数目相关,与肝硬化、肿瘤大小、AFP水平及假包膜无关.survivin阳性组与阴性组术后的1,2,3年的生存率分别为62.0%、40.7%及19.0%和85.9%、59.3%及50.8%(P=0.025).在多变量回归COX分析显示:survivin阳性表达、门静脉癌栓及肿瘤数目是肝癌预后的高危因素,危险度分别为值分别为为1.702、1.994及6.391.结论:survivin过表达可能参与了肝癌的形成和发展,survivin基因的检测有助于有高危肝癌患者的选择,survivin有望成为肝癌治疗的新靶点.

AIM： To analyze the clinical significance of survivin expression in hepatocellular carcinoma （HCC）. METHODS： The expression of survivin was examined by immunohistochemistry and semiquantitative RT-PCR in 76 HCC specimens. The correlation between survivin expression and clinicopathological parameters in HCC were analyzed. Survival data were analyzed using the Kaplan-Meier method and multivariate Cox proportional hazards model. RESULTS： The positive rate of survivin proteinexpression in HCC was 69.74% （53/76）. The relative expression level of survivin mRNA in HCC tissue was signif icantly higher than that in tumor-adjacent normal tissue （0.782 ± 0.284 vs 0.251 ± 0.064, P 0.01）. The positive expression of survivin was correlated with HbsAg positivity, Edmondson grade, portal vein tumor thrombus （PVTT） and tumor number in HCC, but not with cirrhosis, alpha-fetoprotein level, tumor size and pseudocapsule. The 1, 2, 3-year survival rates were 62.0%, 40.7% and 19.0% in survivinpositive group and 85.9%, 59.3% and 50.8% in survivin-negative group, respectively （P = 0.025）. Multivariate Cox regression analysis showed that the positive expression of survivin, PTVV and tumor number were signifi cant prognostic factors for HCC, and the risk ratios were 1.702, 1.994 and 6.391, respectively. CONCLUSION： Overexpression of survivin may be involved in the development and progression of HCC. Detection of survivin expression will be helpful in selecting high-risk HCC patients. Survivin may be a promising target for HCC therapy.