Survivin在喉鳞癌组织中的表达及其与预后的关系

Relationship between Expression of Survivin and Prognosis in Human Laryngeal Squamous Cell Carcinoma

背景与目的:近年来的研究发现,新凋亡抑制基因Survivin表达于多种人类肿瘤,但不表达于正常组织,而其在喉鳞状细胞癌中的表达及意义尚不清楚。本研究旨在了解抗凋亡基因Survivin在喉癌中的表达情况,并分析其作为预测喉癌预后指标的可能性。方法:用免疫组化法检测我科1995～1998年71例喉鳞癌标本中Survivin的表达情况,随访至2003年7月,分析Survivin的表达与喉癌患者年龄、性别、肿瘤分期、临床分型、病理类型、淋巴结转移、远处转移等的关系及其与预后的关系。结果:Survivin在喉鳞癌标本中的阳性率为50.7%(36/71)。在有淋巴结转移的喉癌中阳性率为81.8%(9/11),高于无淋巴结转移者(45.0%,27/60),差异具有显著性(P=0.025)。单因素分析显示肿瘤分期、临床分型及Survivin表达与喉鳞癌的预后有关(P值分别为0.0001、0.009及0.0008);多因素分析显示,排除肿瘤分期及临床分型对喉癌预后的影响后,Survivin表达阳性者中位生存时间(63.5个月)与Survivin表达阴性者(84.0个月)的差异有显著性(P=0.006)。结论:Survivin在部分喉癌组织中有表达,其表达与淋巴结转移有关,并与喉癌的预后相关。

BACKGROUND &OBJECTIVE: A novel inhibitor of apoptosis Survivin has recently been found in many common human cancers but not in normal tissues. Its potential distribution in human laryngeal squamous cell carcinoma (HLSCC) and i ts implication for inhibition of apoptosis were not yet very clear. This study w as designed to investigate the expression of survivin and the probabilities of u sing it as a new indicator of the prognosis of HLSCC. METHODS: HLSCC samples fro m 71 patients treated in Department of Otorhino-laryngology, Second Affiliated Hospital of Sun Yat-sen University between 1995 and 1998 were analyzed for surv ivin expression by immunohistochemistry method. The patients were followed-up f or long term and the relationship between survivin expression and clinical data including age, gender, classification, clinical type, pathological type, lymph n ode metastasis, distant metastasis, and prognosis were analyzed using software S PSS11.0. RESULTS:The expression rate was 50.7%(36/71) in all 71 cases. The expr ession rate was 81.8%(9/11) in the cases with lymph nodes metastasis, which was higher than that in the cases without lymph nodes metastasis (45%, 27/60), wit h significant difference (P=0.025). Univariate analysis revealed that classifi-cation,type and survivin expression were significantly related to the prognosis of HLSCC. P value were 0.0001, 0.009, and 0.0008, respectively. Multivariate ana lysis demonstrated that the patients with positive survivin had significant shor ter survival (63.5 months) than those with negative survivin (84.0 months) (P=0. 006) except the effect of classification and type on the prognosis of HLSCC. CON CLUSION: Survivin expressed in HLSCC especially in the cases with lymph nodes me tastasis. Its expression may related to the prognosis of HLSCC.