P-STAT5和Survivin在结肠腺癌组织中的表达及临床意义

Expression and Clinical Significance of P-STAT5 and Survivin in Colon Adenocarcinoma

目的:探讨活化的转录信号转导子与激活子5(P-STAT5)及凋亡抑制基因蛋白Survivin在结肠腺癌组织中的表达及相关性。方法:采用免疫组织化学SP法检测116例结肠腺癌组织标本中P-STAT5及Survivin蛋白的表达,分析P-STAT5及Survivin的表达与结肠腺癌临床病理因素和预后的关系结果:116例结肠腺癌组织中P-STAT5阳性表达率为61.2%,其异常表达与肿瘤浸润深度(P=0.018)及临床分期(TNM分期)有关(P=0.038),与患者的年龄、性别、肿瘤大小、原发部位、组织分化程度、淋巴结转移、远处转移无关(P>0.05);Survivin阳性表达率为62.9%,其异常表达与各临床病理因素均无关(P>0.05);P-STAT5、Survivin高表达者恶性程度高,预后较差(P=0.015;P=0.025);TNM分期是结肠腺癌独立的预后判定指标(P=0.005);P-STAT5和Survivin的表达均定位于细胞浆,两者之间具有显著正相关性(r=0.268,P=0.004)。结论:P-STAT5和Survivin蛋白在结肠腺癌中均过表达,可能是结肠腺癌发生的早期事件,提示P-STAT5和Survivin的过表达在结肠腺癌发生、发展过程中具有重要作用;两者表达具有相关性,提示P-STAT5与Survivin可能存在一个共同的分子通路,P-STAT5可能是通过上调Survivin表达,抑制细胞凋亡,促进细胞转化,诱导肿瘤的形成;在结肠腺癌组织中检测P-STAT5的表达情况可能对结肠腺癌患者预后判断有参考价值,两者关系的分子基础值得进一步研究。

Objective： To examine the expression of the signal transducer and activator of transcription-5 activation （ phosphory- lated STAT5, P-STATS ） and apoptosis inhibition factor survivin in colon adenocarcinoma tissues, and to determine the correlation between their expression levels and clinicopathologic factors. Methods： S-P immunohistochemical staining was used to detect the expression of P-STATS and survivin among specimens from 116 cases of colon adenocarcinoma and the relationship between expression of these two proteins and various clinicopathologic parameters, including overall survival, were analyzed. Results： The positive expres- sion rate of P-STATS was 61.2% among the samples, which were related to the depth of tumor invasion （ P = 0.018 ） and clinical stages （tumor-node-metastasis stage, TNM stage） （ P = 0.038 ）, but not to age, sex, tumor size, primary site, and differentiation, as well as the incidence of lymph node metastasis and distant metastasis （ P 〉 0.05 ）. The positive expression rate of survivin was 62.9%. No associations were found between survivin expression and the various clinicopathologic parameters （ P 〉 0.05 ）. The cases with high expression levels of P-STAT5 and survivin had high degrees of malignancy and poor prognosis （ P=0.015 and P=0.025 ）. Only the TNM stage was the independent predictor of poor prognosis among the 116 cases of colon adenocarcinoma （ P= 0.005 ）. P-STATS and survivin expression was observed in the cytoplasm of the colon adenocarcinoma cells. There were statistically significant correlations between P-STATS and survivin （ r= 0.268, P = 0.004 ）. Conclusion： Both P-STAT5 and survivin are overexpressed in colon adenocarcinoma, and this overexpression seems to be an early event in the development of colon adenocarcinoma. The overexpression of P-STATS and survivin plays an important role in tumor development and progression. Moreover, the expression of these two gene products is positively correlated. P-STATS and survivin might share a common molecular pathway. P-STAT5 might contribute to tumorigenesis through the upregulation of survivin expression, thereby preventing cell apoptosis, and promoting cell transformation. Determination of the level of P-STATS expression may be useful in predicting the prognosis of patients with colon adenocarcinoma. The molecular basis of such a relationship should be investigated further.