【摘要】 目的 :探讨河南食管癌高发区居民食管癌组织中Survivin蛋白表达的变化特征及其与患者预后的关系。方法 :114例食管癌患者均为高发区居民 ,随访 5a以上。手术切除标本采用常规组织病理学方法和免疫组织化学(ABC)法 ,检测Survivin蛋白在癌细胞中的表达。结果 :Survivin胞浆表达为 6 7/ 114 (5 9% ) ;胞核表达为 5 8/ 114(5 1% ) ;胞浆胞核均表达为 2 4 / 114 (2 1% ) ;13/ 114 (11% )没有出现任何形式的Survivin表达。Survivin核表达阳性和阴性组食管癌患者的平均生存时间及 95 %的可信区间分别为 38(32 ,4 5 )个月和 5 7(5 1,6 4 )个月 ,Survivin核表达阳性患者生存期明显小于阴性表达者 (P <0 .0 5 ) ;Survivin胞浆表达组患者的平均生存时间及 95 %的可信区间为 5 0(4 4 ,5 5 )个月 ,与Survivin阴性表达患者生存期间差异无统计学意义 (P >0 .0 5 )。Sperman秩相关分析结果表明Sur vivin核阳性表达与食管癌细胞浸润深度相关 (P <0 .0 5 ) ,多因素Cox模型逐步回归分析结果显示“TNM分期”、“分化程度”和“Survivin核表达”3种因素对患者生存期的影响最大。结论 :Survivin蛋白胞核阳性表达是食管癌患者预后不良的标志 ,可能作为一种独立预后指标 ;Survivin蛋白胞浆表达与食管癌患者的预后无相关性更多还原

【Abstract】 Aim: To investigate the expression of Survivin in esophageal squamous cell carcinoma (ESCC) at high-incidence area and its relationship with esophageal cancer prognosis. Methods: A total of 114 cases of ESCC were collected from Linzhou city, and all patients were followed up more than 5 years after surgery. Histopathological analysis and immunohistochemical staining (ABC) were applied to detect the expression of Survivin. Results: Survivin was detected in the cytoplasm in 67/114 (59%) and in the nucleus in 58/114(51%)cases with ESCC; 24/114 (21%) cases demonstrated both nuclear and cytoplasmic staining,and there was no any expression in 14/114(11%) cases. The mean survival periods and 95 confidence interval of those with positive nuclear expression of Survivin and with negative expression were 38 (32, 45) and 52 (45, 59) months, respectively. Patients with positive nuclear expression obviously survived less than those with negative expression, and the difference was significant (P<0.05). The expression of Survivin in cytoplasm showed no correlation with patients prognosis(P>0.05). Itwas shown by stepwise multivariate analysis that differentiation, nuclear expression of Survivin,and TNM staging were the most important factors affecting the prognosis of ESCC (P<0.05). Conclusion: The expression of Survivin protein in nuclear may be an independent prognostic indicator for poor prognosis of ESCC, while the expression in cytoplasm has no relationship with the prognosis of ESCC.更多还原