晚期乳腺癌患者生存素的表达与放疗敏感性之间的关系

Relationship between expression of survivin and radiation sensitivity in patients with advanced breast cancer

目的探讨晚期乳腺癌患者生存素(survivin)的表达与放疗敏感性的关系。方法选取2012年1月至2014年1月南京医科大学附属淮安第一医院首诊并确诊的66例晚期乳腺癌(局部T4期)女性患者作为研究对象,入组患者均采用放射治疗,根据放疗敏感性分为放疗敏感组(37例)和放疗不敏感组(29例)。取患者放疗前活检组织标本,采用免疫组化技术法检测survivin蛋白的表达情况,采用逆转录聚合酶链反应(RT-PCR)检测survivin的mRNA表达情况,采用原位末端转移酶标记技术(TUNEL)检测标本中细胞凋亡指数。结果 survivin蛋白在放疗敏感组和放疗不敏感组的高表达率分别为21.6%(8/37)和75.9%(22/29),两组比较差异有统计学意义。RT-PCR发现,与放疗敏感组相比,放疗不敏感组survivin mRNA的表达明显上升,差异有统计学意义(P<0.05)。TUNEL检测细胞凋亡显示,放疗敏感组细胞凋亡指数显著高于放疗不敏感组,差异有统计学意义(P<0.05)。survivin高表达细胞凋亡指数显著低于低表达,差异有统计学意义(P<0.05)。结论survivin的表达与晚期乳腺癌的放疗敏感性呈显著负相关,表明survivinde的表达可以作为预测晚期乳腺癌患者放疗敏感性的分子指标,可以作为指导患者制定合理治疗方案的新指标,从而实现患者个体化治疗。

Objective To examine the relationship between expression of survivin and radiation sensitivity in patients with advanced breast cancer. Methods Select 66 female patients initially treated and diagnosed with advanced breast cancer（ local,T4 stage） at Huaian First People＇s Hospital,Nanjing Medical University from January 2012 to January 2014. After the enrollment,all the patients received radiotherapy. According to radiation sensitivity,patients were classified into sensitive group（ 37 cases） and non-sensitive group（ 29 cases）. Using patients＇ histological specimen collected before radiotherapy and by immunhistochemical staining method,the expression of survivin protein was detected,reverse transcription-polymerase chain reaction（ RT-PCR） was used to detect the expression of survivin mRNA,Td T-mediated d UTP nick end labeling（ TUNEL） was used to detect apoptotic index（ AI） of tissue specimens. Results High expression rate of survivin in sensitive group and non-sensitive group were 21. 6%（ 8 /37） and 75. 9%（ 22 /29） respectively（ P〈 0. 05）. RT-PCR trial found that RQ of survivin mRNA in non-sensitive group was significantly higher than those of sensitive group（ P〈 0. 05）. TUNEL dectetion revealed that AI in sensitive group was significantly higher than those of non-sensitive group（ P〈 0. 05）. AI in high survivin expression group were significantly lower than those of low survivin expression group（ P〈 0. 05）. Conclusion The expression of survivin had a negative correlation with radiation sensitivity,which could be a useful predictor of radiosensitivity for advanced breast cancer. Survivin could be used as a new index to guide formulating reasonable treatment so as to realize individualized treatment.