survivin和p53表达水平对直肠癌分级和预后影响分析

Analysis of the effect of Survivin and p53 expression levels on the grading and prognosis of rectal cancer

目的 探讨survivin和p53表达水平对直肠癌分级和预后影响分析。方法 选取2010年1月到2015年10月住院治疗的经组织病理确诊的直肠癌患者83例,比较患者不同病理分化程度、TNM分期、DUKEs临床分期的survivin和p53阳性表达率的差异;以及不同survivin和p53表达结果的生存时间分析。用SPSS16.0软件进行统计分析数据,survivin和p53阳性表达率用（%）表示,采用卡方检验;二者阳性表达率与直肠癌不同分期的相关性分析用Spearman法;不同survivin和p53表达结果的生存时间分析用kaplan-Meier法,P〈0.05表示差异具有统计学意义。结果 83例患者中survivin表达阳性49例,阴性34例,阳性率为59.04%;p53表达阳性57例,阴性26例,阳性率为68.67%。survivin和p53在病理分化程度高、TNM分期高的患者中阳性表达率较高,病理分化程度、TNM分期与survivin和p53表达阳性率呈正相关。survivin阳性表达的患者5年随访期中位生存时间44个月显著的低于survivin阴性表达的患者的48个月（log-rankχ^2=10.955,P=0.001）;p53阳性表达的患者5年随访期中位生存时间42个月显著低于p53阴性表达的患者的46个月（log-rankχ^2=6.128,P=0.013）。结论 survivin和p53的阳性表达与直肠癌分级和生存时间密切相关。

Objective To investigate the influence of surviving and p53 expression on the grading and prognosis of rectal cancer. Methods 83 cases of rectal cancer diagnosed by histopathology were selected in our hospital form January 2010 to October 2015, and the differences of survivin and p53 positive expression were compared between patients with different pathological differentiation degree, TNM stage and clinical stage of DUKEs. The relation between survivin and p53 expression and survival period of patients with rectal cancer was also analyzed. SPSS16. 0 statistical software was used, and survivin and p53 expression were represented as percentage, with chi square test for statistical comparison. Spearman test was used for analyzing the relationship between positive expression and different stages of rectal cancer. Kaplan-Meier method was used for analyzing the relationship between the survival time and survivin and p53 expresslon, P 〈 0.05 was regarded to be statistically significant. Results he expression of survivin was positive in 49 cases, with a positive rate of 59.04% , and the expression of p53 was positive in 57 cases, with a positive rate of 68.67%. The expressions of survivin and p53 were significantly high in patients with higher pathological differentiation and higher TNM stages. TNM stages were also positively correlated with the expressions of survivin and p53. The median survival time of patients with positive expression of surviving was 44 months which was significantly different from that of patients with negative positive expression of surviving （48 months） （log-rank χ^2 = 10. 955, P=0. 001 ）. Similar results were also identified in the expression of p53 （42 months of patients with p53 positive expression; 46 months of patients with p53 negative expression （log-rank χ^2 = 6. 128, P = 0. 013 ）. Conclusion The positive expression of survivin and p53 was closely related to the grade of rectal cancer and the survival time of patients with rectal cancer.