联合评估survivin和p53在胃癌组织中表达的临床意义及对预后的影响  

Combined evaluation of the clinical significance and prognosis of survivin and p53 expressions in gastric cancer

作　　者：俞继卫[1] 姜波健[1] 倪晓春[1] 吴巨钢[1] 李小强[2] 

机构地区：[1]上海交通大学医学院附属第三人民医院普外科,上海201900 [2]上海交通大学医学院附属第三人民医院病理科,上海201900

出　　处：《国际外科学杂志》2007年第3期156-160,F0003,共6页International Journal of Surgery

基　　金：上海市卫生局科研资助项目（No.034086）

摘　　要：目的 研究胃癌原发灶中survivin和p53的表达与临床病理特征，恶性潜能及预后的影响。方法 免疫组化法检测125例行根治切除胃癌组织中survivin和p53表达情况，采用单因素和多因素分析比较survivin和p53表达及其共同表达与临床病理特征和预后关系。结果 survivin和p53表达阳性率各自为57．6％（72例／125例）和59．2％（74例／125例）。survivin阳性表达率在弥漫型和组织分化差（均P〈0．01）、肿瘤浸润更深、有淋巴结转移、淋巴管浸润及进展期（P〈0．05）胃癌组织中显著增高。p53表达与淋巴结转移和淋巴管浸润（P〈0．037）相关。单因素分析显示，survivin和p53表达阳性分别与5年生存率有关（P=0．0050和P=0．0025）。多因素分析显示，survivin和p53共同表达患者预后更差（P=0．001）。结论 survivin和p53在胃癌组织中均有较高的表达率，survivin阳性表达和p53阳性表达分别提示预后不良，survivin和p53共同表达为胃癌根治术后独立的预后因子。Objective To study the relationship between survivin expression and p53 expression with the clinicopathologic variables and whether the aberrant expressions of both survivin and p53 is related to the increase of the malignant potential in gastric cancer. Methods Specimens from 125 cases with gastric cancer treated with radical resection were evaluated for both expressions of survivin and p53 by immunohistochemical stainings respectively. The correlations between the expressions of p53 and survivin alone or the coexpressions and the clinicopathologic profiles as well as theirs prognosis were statistically analyzed. Results The survivin expression and the p53 expression were positive in 72 of 125 cases （57.6%） and 74 of 125 cases （59.2%） respectively. The incidence of survivin expression was significantly higher in Lauren type and poor differentiation（ both P 〈0.05）, deeper invasion, lymph node metastasis, lymphatic invasion, and advanced stages（ P 〈0.05, respectively）. Expression of 1153 was correlated with lymph node metastasis and lymphatic invasion respectively（ P =0. 013 ; P =0.037 ）. Univariate analysis showed that either survivin expression or p53 expression was significantly correlated with 5-year survival rate respectively （ P =0. 0050, P =0. 0025 ）. Multivariate analysis with the Cox regression models showed that coexpression of survivin and p53 was significantly associated with poor prognosis （P = 0. 001 ） Conclusions Upregulated expressions both survivin and p53 of are the common event in gastric cancer. The coexpression of survivin and p53 was the independent prognosis factor for gastric cancer.

关 键 词：胃 新生物/癌 SURVIVIN P53 预后 

分 类 号：R735[医药卫生—肿瘤]