动脉化疗栓塞对膀胱癌组织中Survivin表达的影响  

Influence of preoperative arterial chemoembolization on expression of Survivin in bladder cancer

作　　者：邵四海[1,2] 王荣江[1,2] 石麒麟[3] 赵红星[4] 郑银元[4] 陈晓农[1,2] 

机构地区：[1]湖州师范学院附属第一医院,313000 [2]浙江省湖州市第一人民医院泌尿外科,313000 [3]浙江省湖州市第一人民医院病理科,313000 [4]浙江省湖州市第一人民医院放射介入科,313000

出　　处：《中国医师进修杂志》2014年第35期20-23,共4页Chinese Journal of Postgraduates of Medicine

基　　金：浙江省医药卫生科技计划（2012KYB199）;浙江省湖州市科技项目（2013GYB07）

摘　　要：目的 探讨术前动脉化疗栓塞对膀胱癌组织凋亡抑制基因Survivin表达的影响及其临床意义.方法 对50例膀胱癌患者化疗栓塞前后的肿瘤组织,应用免疫组织化学法测定Survivin的表达,比较化疗栓塞前后膀胱癌组织中Survivin的表达程度,并分析Survivin与膀胱癌病理分级和临床分期的关系.结果 Survivin阳性表达率在化疗栓塞前随着肿瘤的病理分级、临床分期的升高而增加,差异有统计学意义（P＜0.05）.化疗栓塞前后Survivin阳性表达率分别为72％（36/50）,22％（11/50）,差异有统计学意义（P＜0.01）,高级别及T2～T4期Survivin阳性表达率在化疗栓塞后明显降低,差异有统计学意义（P＜0.01）.经随访化疗栓塞后3年生存率Survivin阴性表达患者[94.87％（37/39）]高于阳性表达患者（7/11）,但差异无统计学意义（P＞0.05）.复发患者化疗栓塞后Survivin阳性表达率（5/8）明显高于无复发患者[5.56％（2/36）],差异有统计学意义（P＜0.01）.结论 术前化疗栓塞能降低膀胱癌组织Survivin的表达,调节膀胱癌的分化程度,使肿瘤降级降期,降低复发率.Survivin的表达可作为膀胱癌预后估计的指标.Objective To investigate the influence of preoperative arterial chemoembolization on the expression of Survivin,and study the clinical significance in bladder cancer.Methods The tissue before and after chemoembolization of 50 patients with bladder cancer were selected,the Survivin expression was examined by immunohistochemical method.The Survivin expression was compared between before and after chemoembolization in bladder cancer tissue,and the relation of its expression to the pathological grade and clinical stage was evaluated clinically.Results The positive rate of Survivin expression before chemoembolization raised with the rising of the pathological grade and clinical stage,there was statistical difference （P 〈 0.05）.The positive rate of Survivin expression before and after chemoembolization was 72% （36/50） and 22% （11/50）,there was statistical difference （P 〈0.01）.The positive rate of Survivin expression in high grade pathological grade and T2-T4 clinical stage after chemoembolization was significantly lower than that before chemoembolization,there was statistical difference （P 〈0.01）.The survival rate 3 years after chemoembolization in Survivin negative expression patients was higher than that in Survivin positive expression patients [94.87%（37/39） vs.7/11],but there was no statistical difference （P 〉 0.05）.The Survivin positive expression in recurrence patients was significantly higher than that in non-recurrence patients [5/8 vs.5.56% （2/36）],there was statistical difference （P 〈 0.01）.Conclusions Preoperative arterial chemoembolization can reduce the expression of Survivin,adjust malignancy of bladder cancer,could downgrade and downstage the tumor,reduce recurrence rate.The expression of Survivin can serve as predictive factor for prognosis of bladder cancer.

关 键 词：膀胱肿瘤 化学栓塞 治疗性 

分 类 号：R737.14[医药卫生—肿瘤]