Survivin在食管鳞癌中的表达和定位与细胞增殖和凋亡及与预后的关系  

Expression and localization of survivin associates with cell proliferation, apoptosis and the prognosis significance in squamous cell carcinoma of esophagus

作　　者：张诗杰[1] 陈鸿义[1] 卜定方[2] 刘桐林[1] 李简[1] 

机构地区：[1]北京大学第一医院胸外科,北京100034 [2]北京大学第一医院中心实验室,北京100034

出　　处：《中国现代医学杂志》2005年第20期3065-3068,共4页China Journal of Modern Medicine

摘　　要：目的探讨survivin在食管鳞癌组织中的表达情况与细胞增殖和凋亡的关系,以及survivin在细胞中的定位与预后的关系。方法对2001年11月￣2003年1月手术获得的24例食管鳞癌标本以免疫组化方法测定survivin和PCNA(增殖细胞核抗原)的表达,以阳性细胞比例和染色强度的乘积作为积分判定表达情况;以TUNEL法(脱氧核糖核苷酸末端标记法)检测细胞凋亡。对染色情况用SPSS软件进行分析,判断sur-vivin和细胞增殖与凋亡的关系,以及survivin在细胞中的定位与预后的关系。结果24例中survivin总阳性率为62.5%(15/24),积分平均为(1.92±2.32)。统计分析显示食管鳞癌中肿瘤分化程度不同,survivin表达差异有显著性(P<0.05),分化越差,survivin的阳性率越高;而患者年龄、性别、肿瘤部位、大小、侵犯深度、有无淋巴结转移以及TNM分期均与survivin的阳性率无关(P>0.05)。24例中PCNA的表达阳性率为83.3%(20/24),增殖指数(PI)平均(44.82±29.36)%,凋亡指数(PI)平均(3.79±3.30)%。survivin阳性组PI高于阴性组(P<0.02),而AI低于阴性组(P<0.05)。survivin阳性组生存时间与阴性组差异无显著性,而胞核表达survivin的患者生存时间小于单纯胞浆表达者(P<0.05)。Cox模型多因素生存分析显示survivin积分、肿瘤分化、大小、TNM分期是影响预后的因素。结论食管鳞癌组织中survivin阳性表达者,其细胞增殖活跃,且凋亡受到抑制;胞核表达survivin的患者生存时间少于单纯胞浆表达者,胞核表达survivin预后不佳。[Objective] To investigate the relationship of survivin, cell proliferation and apoptosis in squamous cell carcinoma of esophagus and prognostic significance of survivin＇ s subcellular localization. [Methods] The expression of survivin and PCNA was examined by immunohistochemical stain in postoperative samples from 24 patients with squamous cell carcinoma of esophagus, the percentage of positive staining cell and the intensity of staining were multiplied, the product as score was to evaluate the expression of the destination gene. The apoptosis was detected by TUNEL method. The data was analyzed with SPSS software. [Results] Survivin positive rate was 62.5%, mean score was （1.92±2.32）. The difference of survivin expression was prominence with tumor cell differentiation （P 〈0.05）, whereas had no relationship with patient＇ s age, gender, tumor＇ s location, size, invade depth, lymph node metastasis and TNM staging （P 〉0.05）. The mean proliferation index（Pl） was （44.82±29.36）%, and the mean apoptosis index（AI） was （3.79±3.30）%, PI was higher in the sample with positive survivin staining than in that with negative （P 〈0.02）, and the reverse situation was found with AI. The postoperative survival in survivin positive patients had no difference with that in negative ones（P〈0.05）,whereas nuclear positive linked with shorter postoperative survival compare with plasma positive,Cox survival analysis showed score of survivin,tumor＇s differentiation,size and TNM classilication were the prognostic factors,[Conclusion]Positive expression of survivin in squamous cell carcinoma of esophagus was concomitant with active cell proliferation and suppression of apoptosis,Postoperative survival was shorter in nuclear survivin positive patients than that in plasma positive ones,nuclear survivin positive prompted poor prognosis.

关 键 词：SURVIVIN 增殖 凋亡 食管鳞癌 预后 

分 类 号：R735.1[医药卫生—肿瘤]