β-catenin、survivin在Ⅰa1～Ⅱa2期宫颈癌中的表达及其临床意义

The Expressions and Clinical Significance of β- catenin and Survivin in StageⅠa1-Ⅱa2 Cervical Cancer

目的探讨β-catenin、survivin在Ⅰa1~Ⅱa2期宫颈癌中的表达及其临床意义。方法收集2011年1月至2013年3月保定第七医院妇科收治的121例宫颈癌患者为研究对象。利用免疫组化法检测宫颈癌组织中survivin、β-catenin的表达情况,分析二者表达与宫颈癌临床病理参数的关系。采用门诊、电话等形式进行随访,分析二者表达对患者5年生存率的影响。结果①β-catenin主要表达于肿瘤细胞的细胞膜,在细胞浆中也有少量表达,阳性率为81.8%(99/121)。survivin主要定位于肿瘤细胞的细胞核及细胞浆,阳性率为71.9%(87/121)。②Logistic多因素分析发现,仅有FIGO分期是影响β-catenin、survivin阳性表达的独立性危险因素(P<0.05)。③存在淋巴结转移的患者β-catenin表达强度显著较高(Z=-3.584,P<0.001),但β-catenin表达强度对腹主动脉旁淋巴结转移无明显影响(P>0.05)。存在淋巴结转移及腹主动脉淋巴结转移患者的survivin表达强度显著较高(P<0.05)。④Spearman相关性检验结果显示,β-catenin与survivin表达之间存在显著的正相关关系(r=0.414,P<0.001)。⑤随访时间截至2018年3月,失访17例,成功随访104例,有效随访率为85.9%。中位随访时间56个月,104例患者中,死亡43例,存活61例。Log-rank检验显示,β-catenin(-)组患者生存率显著好于β-catenin(+)组(χ^2=4.603,P=0.031),survivin(-)组患者生存率显著好于survivin(+)组(χ^2=13.870,P<0.001)。结论β-catenin、survivin在宫颈癌中阳性率较高,表达存在正相关关系,对患者预后有明显的消极影响,可作为判断患者预后的潜在指标。

Objective To investigate the expressions and clinical significance of β-catenin and survivin in stage I a1-II a2 cervical cancer.Methods A total of 121 patients with cervical cancer were selected as the study subjects.Immunohistochemical method was used to detect the expressions of survivin and β-catenin in cervical cancer tissues,and the relationship between the expressions of these two genes and clinical pathological parameters of cervical cancer was analyzed.With the follow-up through clinical visits or phone conversatios,the effect of the expressions of these two markers on the 5-year survival rate was analyzed.Results(1)The expression of β-catenin was mainly in the cell membrane of tumor cells,and a small amount was expressed in cytoplasm,with a positive rate of 81.8%(99/121).Survivin was mainly localized in the nucleus and cytoplasm of tumor cells,with a positive rate of 71.9%(87/121).(2)Only FIGO stage was an independent risk factor affecting the positive expressions of the two markers(P<0.05).(3)The expression intensity of β-catenin in patients with lymph node metastasis was significantly higher(Z=-3.584,P<0.001),but the expression intensity of β-catenin had no significant effect on the lymph node metastasis of abdominal aorta(P>0.05).The expression level of survivin in patients with lymph node metastasis and abdominal aortic lymph node metastasis was significantly higher(P<0.05).(4)Spearman correlation test showed that there was a positive correlation between β-catenin and survivin expression(r=0.414,P<0.001).(5)The follow-up period was up to March 2018,and the effective follow-up rate was 85.9%(104/121).The median follow-up period was 56 months.Among the 104 patients,43 died and 61 survived.Log-rank test showed that the survival rate of the patients in group β-catenin(-)was better than that of the group of β-catenin(+)(χ^2=4.603,P=0.031),and the survival rate of the group survivin(-)group was better than that of the survivin(+)group(χ^2=13.870,P<0.001).Conclusion β-catenin and Survivin have a relative high positive rate in cervical cancer,and there is a positive correlation in the expression between these two.It has a significant negative effect on the prognosis of the patients,which can be used as the potential prognostic indicators.