骶骨脊索瘤中生存素的表达及其临床意义  

Expression of survivin in sacral chordoma and its clinical significance

作　　者：陈超[1] 杨惠林[1] 陈康武[1] 王根林[1] 胡海[1] 黄永丰 

机构地区：[1]苏州大学附属第一人民医院骨科,江苏苏州215006 [2]苏州枫桥人民医院骨科,江苏苏州215001

出　　处：《中国医药导报》2013年第14期42-44,47,共4页China Medical Herald

摘　　要：目的研究骶骨脊索瘤组织中生存素（survivin）的表达情况，为骶骨脊索瘤的预后判断和靶向治疗提供理论依据。方法通过对苏州大学附属第一人民医院2000年1月～2010年7月住院患者进行筛选和随访，获得完整病例资料和肿瘤组织蜡块标本30例以及瘤旁正常组织标本10例；采用SP免疫组织化学法检测上述标本中survivin与CD34的表达情况，利用CD34标记组织中的微血管；统计分析survivin在骶骨脊索瘤组织与瘤旁组织中表达的差异性；统计分析微血管密度（microvessel density，MVD）在肿瘤组织与瘤旁组织．肿瘤组织survivin阳性组与阴性组中的差异性；肿瘤组织中survivin的表达与性别、年龄、肿瘤大小、肿瘤部位、肿瘤部位、复发情况有无相关性；对复发结果进行Kaplan—Meier单因素分析并绘制无瘤生存期（CDFS）曲线．用Log—Rank法进行假设检验。结果①survivin在骶骨脊索瘤中的阳性表达率为70．0％，高于瘤旁组织（P〈0．05）。骶骨脊索瘤中MVD值为（27．2±10．70）／mm^2，高于瘤旁组织（8．90±3．11）／mm^20（P〈0．05）；②survivin阳性表达的骶骨脊索瘤组织中MVD值为（30．71±10．35）／mm^2。明显高于survivin阴性组的（19．00±6．25）／mm^2（p〈0．05）：③survivin的表达与患者肿瘤有无局部浸润、是否复发相关（P〈0．05）；④骶骨脊索瘤患者survivin阳性组术后中位CDFS期24个月明显低于阴性组50个月（P=0．005）。结论①骶骨脊索瘤组织中survivin表达水平较高，尤其是在血管丰富的脊索瘤组织中，survivin对骶骨脊索瘤的血管生成可能起正向调节作用．survivin可作为骶骨脊索瘤血管靶向治疗的一个新靶点；②survivin高表达是骶骨脊索瘤患者术后持续CDFS的独立预测因素。Objective To investigate the expression of survivin in human sacral chordoma tissues, so as to provide theoretical basis for prognosis and molecular targeted therapy. Methods Through the inclusion and exclusion criteria for screening and follow-up to the hospitalized patients from January 2000 to July 2010, the complete medical records, tumor tissue paraffin block specimens of 30 cases and tumor adjacent normal tissue in 10 cases are obtained; Expressions of survivin and CD34 was detected in 30 cases of human sacral chordoma tissues and 10 normal notochord tissues through SP immunohistochemistry, with micro-vessel in chordoma tissues marked with CD34; Statistical analysis was used to tell the difference of survivin expression between the sacral chordoma tissue and normal notochord tissues; Statistical analysis was used to tell the difference of MVD between the sacral chordoma tissue and normal notochord tissues and that between the positive and negative expression of survivin and VEGF in the sacral chordoma tissue; Whether the expression of survivin in tumor tissue strength was related to gender, age, tumor size, tumor location, and tumor recurrence was included; single factor in the Kaplan-Meier analysis of recurrence results was included and CDFS curve was drawn, and also Log-Rank method was used for hypothesis testing. Results ①The positive expression rate of survivin in chordoma was 70.0%, which was significantly higher than its in the normal notochord tissues （P 〈 0.05）; the MVD marked by CD34 was （27.2±10.70）/mm^2 in the chordoma tissues much higher than that （8.90±3.11）/ mm^2 in the normal notochord tissue, there was significant difference （P 〈 0.05）. ②The MVD in the positive expression group of survivin was （30.71±10.35）/mm^2. It was significantly higher than that in the negative expression group （19.00± 6.25）/mm^2 （P 〈 0.05）.③The positive rate of survivin was correlated significantly with tumor invasion of the surrounding muscle and recurrence （P 〈 0.05）;

关 键 词：骶骨 脊索瘤 生存素 微血管密度 免疫组织化学 

分 类 号：R738.1[医药卫生—肿瘤]