原发性肝外胆管癌Survivin蛋白表达及其在转归评估中的价值  

Expression of Survivin protein in primary extrahepatic cholangiocarcinoma and its value for assessing the prognosis

作　　者：孙广增[1] SUN Guang-zeng(Department of General Surgery, Aryang People’s Hospital,Anyang, Henan 455000, China)

机构地区：[1]安阳市人民医院普通外科,河南安阳455000

出　　处：《肝胆胰外科杂志》2017年第4期319-323,共5页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨Survivin蛋白在原发性肝外胆管癌(primary extrahepatic cholangiocarcinoma,PECC)的表达和转归评估中的价值。方法选择1996年1月至2014年12月安阳市人民医院普外科168例PECC标本和60例正常胆管组织,进行免疫组织化学(IHC)法检测Survivin蛋白的表达情况及其在PECC转归评估中的作用。结果 IHC显示Survivin蛋白主要存在于细胞胞质中,在65%(110/168)的PECC标本中能检测到Survivin蛋白。T_3~T_4期患者Survivin蛋白高表达率显著高于T_1~T_2期患者(P=0.004),N_0~N_1期患者Survivin蛋白高表达率显著高于N_2~N_3期患者(P<0.001),中~低分化患者Survivin蛋白高表达率显著高于高分化患者,差异有统计学意义(P<0.001)。在PECC根治术后,Survivin蛋白高表达组生存期短,平均生存时间为17个月;而低表达组生存期长,平均生存时间为93个月,差异有统计学意义(P<0.001)。Survivin蛋白表达是PECC的一个独立的术后结局预测因素(RR=6.047,95%CI:2.696~13.562,P<0.001)。结论 Survivin蛋白在约65%PECC标本中能检测到,其表达量与PECC患者生存时间成反比,可作为PECC转归评估的独立预测因素。Objective To evaluate the expression of Survivin protein in primary extrahepatic cholangiocarcinoma(PECC)and its value for assessing the prognosis.Methods From Jan.1996to Dec.2014,a total of168cases of PECC specimens and60cases of normal bile duct tissues were collected in Anyang People’s Hospital.The expression of Survivin protein was detected by immunohistochemistry(IHC).Results Specific Survivinprotein mainly existed in cell cytoplasm.Survivin protein can be detected in110/168(65%)of the PECC’s specimen.Survivin protein with DAB staining positive in T3-T4patients was significantly higher than that in T1-T2patients(P=0.004).Survivin protein with DAB staining positive in N0-N1patients was significantly higher thanthat in N2-N3patients(P<0.001).Survivin protein with DAB staining positive in moderately to poorly differentiatedpatients was significantly higher than that in well differentiated patients,and the difference was statisticallysignificant(P<0.001).After PECC radical surgery,group with high Survivin expression had a short survivaltime of17months,while the group with low expression had a long survival time of93months.Survivin proteinexpression was an independent predictor of postoperative outcome of PECC(RR=6.047,95%CI:2.696-13.562,P<0.001).Conclusion Survivin protein is expressed in about65%PECC samples.The expression level is inverselycorrelated to the survival time in patients with PECC.It can be used as an independent factor for predictingthe prognosis of PECC.

关 键 词：原发性肝外胆管癌 SURVIVIN蛋白 转归 

分 类 号：R735.8[医药卫生—肿瘤]