Survivin表达对胃癌患者预后影响的Cox多因素分析

Cox Multivariate Analysis of Survivin on the Prognosis of Gastric Carcinoma

目的探讨Survivin在胃癌组织中表达情况以及对胃癌患者生存期的影响。方法采取免疫组织化学方法检测Survivin在胃癌组织的表达情况,根据Survivin是否表达将103例胃癌患者分成Survivin阳性表达组和阴性表达组,使用Kaplan-Meier生存分析法评估2组患者的生存率,并采用Cox模型多因素分析胃癌患者死亡的影响因素。结果 Survivin在胃癌组织中表达阳性率为71.8%,2组患者在胃癌的临床分期（χ^2=6.434）、分化程度（χ^2=13.026）、淋巴结是否转移（χ^2=5.543）等方面差别有统计学意义（均为P〈0.05）。Kaplan-Meier生存分析表明,Survivin阳性表达组中位生存期为22月,而阴性表达组为40月。Log-rank检验提示,两条生存曲线差别有统计学意义,Survivin阳性表达组胃癌患者生存率明显低于阴性表达组（χ^2=15.69,P〈0.001）;Cox多因素分析显示,调整了年龄、性别、肿瘤分期、分化程度、治疗方式等因素后,Survivin阳性表达组患者死亡风险增加（HR=2.651,95%CI1.434-4.900,P=0.002）。结论 Survivin表达与胃癌患者的生存时间密切相关,是影响胃癌患者生存期的独立危险因素。

Objective To investigate the expression of Survivin in gastric carcinoma tissue and its effect on survival in patients with gastric cancer. Methods Immunohistochemical method was used to detect the expression of Survivin in gastric carcinoma tissues. According to whether Survivin in gastric carcinoma was expressed,we divided the patients into two groups. The survival rate was analyzed with Kaplan-Meier survival analysis,and predictors analysis for the death of gastric carcinoma patients was performed with Cox proportional hazards regression model. Results The positive expression rate of Survivin in gastric carcinoma tissues was 71.8%. There were significant differences between the two groups（Survivin positive group vs Survivin negative group）in clinical TNM stage（χ^2=6.434,P〈0.05）,tissue differentiation（χ^2=13.026,P〈0.05）and lymphnode metastasis（χ^2=5.543,P〈0.05）. Kaplan-Meier survival analysis demonstrated that median survival times for the Survivin positive expression group and negative expression group were 22 months and 40 months respectively. The Log-rank test revealed that there wassignificant difference between the two survival curves,and the survival rate of Survivin positive expression group was lower than the group with Survivin negatively expressed（χ^2=15.69,P〈0.001）.Cox proportional hazards regression analysis indicated,adjusted forage,sex,clinical TNM stage,differentiation and treatments,that the risk of mortality was increased in Survivin positive expression group（HR=2.651,95% CI 1.434-4.900,P=0.002）. Conclusion Survivin expressed in gastric carcinoma was closely correlated with the survival time of those patients,It is an independent prognostic factor in patients of gastric carcinoma.