胃癌患者IL-11和Survivin高表达的临床病理学意义及其在癌进展和生存预后中的作用

Clinicopathological and prognostic significance of IL-11 and Survivin overexpression in gastric cancer

目的:通过检测信号传导与转录激活因子3(signal transducer and activator of transcription 3,Stat3)信号通路相关分子白介素-11(interleukin-11,IL-11)及存活素(Survivin)在胃癌患者组织中的差异性表达,探讨IL-11和Survivin在胃癌发生、进展、转移及预后中的作用.方法:收集2004-01-01/2007-12-31于石河子大学医学院第一附属医院手术的59例胃癌患者的胃癌及其癌旁5 cm石蜡包埋组织,制作组织芯片.采用免疫组织化学Envision法检测组织中IL-11和Survivin的表达水平.对59例胃癌患者进行了124 mo(10.3年)的随访,并结合患者的临床病理特征及随访资料进行了分析.结果:(1)I L-11在胃癌组织中的表达率为96.6%(57/59)高于癌旁正常组织88.1%(52/59)(χ2=7.252,P=0.025);Survivin在胃癌组织中的表达率为93.2%(55/59)明显高于癌旁正常组织72.9%(43/59)(χ2=41.988,P<0.001).在胃癌组织中IL-11和Survivin的表达呈明显正相关(r=0.442,P<0.001);而在癌旁组织却并未存在这种相关性(r=0.103,P=0.438);(2)I L-11的高表达与较高的胃癌临床分期显著相关(P=0.002);而Survivin的高表达则与胃癌的淋巴结转移和较高的临床分期相关(P=0.028,0.002);(3)首次提出IL-11和Survivin的高表达都与胃癌患者的生存预后不良相关,表达越高,预后越差(P=0.004,P<0.001);(4)C o x多因素回归模型分析提示,临床分期是影响胃癌患者生存预后的独立危险因素(P=0.017).结论:胃癌患者IL-11和Survivin的高表达与患者的生存预后不良相关,且二者在胃癌的发生、发展及预后过程中可能存在协同作用.

AIM： To investigate the differential expression of interleukin-11（IL-11） and Survivin in gastric cancer（GC） to understand their possible roles in carcinogenesis, progression and prognosis. METHODS： Paraffin-embedded samples were obtained from 59 GC patients who underwent surgical operations at the First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, China, between January 1, 2004 and December 31, 2007. All of the patients were followed to April 1, 20014. The expression of IL-11 and Survivin was detected using tissue chip and immunohistochemistry. RESULTS： The positive expression rate of IL-11 was 96.6% in GC tissues, significantly higher than that in adjacent normal tissues（88.1%; χ2= 7.252, P = 0.025）. The positive expression rate of Survivin in GC tissues was also significantly higher than that in adjacent normal tissues（93.2% vs 72.9%, χ2 = 41.988, P 0.001）. In GC tissues, there was a positive correlation between IL-11 and Survivin expression（r = 0.442, P 0.001）, but no correlation was found in adjacent normal tissues（r = 0.103, P = 0.438）. The expression of IL-11 was correlated with higher clinical stage（P = 0.002）, while Survivin expression was correlated with lymph node metastasis and higher clinical stage（P = 0.002, 0.028）. Higher levels of IL-11 and Survivin were linked to poor prognosis in GC patients（P = 0.004 and P 0.001, respectively）. Cox multi-factorial regression analysis demonstrated clinical stage being an independent factor predicting overall survival of GC patients（P = 0.017）. CONCLUSION： Overexpression of IL-11 and Survivin correlates with poor prognosis of GC patients, and they may play a coordinated role in the development, progression and prognosis of GC.