【摘要】 背景与目的:分析膀胱移行细胞癌肿瘤组织中Survivin和P53蛋白的表达情况,并探讨它们与肿瘤复发的关系。材料与方法:应用免疫组织化学方法检测75例膀胱移行细胞癌石蜡包埋肿瘤组织中Survivin和P53蛋白的表达。并按照患者临床病理级别分层,使用Mantel_Haenszel等统计学方法分析上述两种蛋白的表达与膀胱癌复发的相对危险度及显著性水平。结果:膀胱癌组织Survivin蛋白在胞浆、胞核检出率和P53蛋白的阳性检出率分别为76.0%、30.7%和53.33%;Survivin(胞浆)与P53并联使用阳性检出率为84.0%。以Survivin蛋白的胞浆、胞核的表达和P53蛋白表达、以及二者并联使用预测膀胱癌复发的灵敏度分别为87.50%、37.50%、71.88%和96.88%;特异度分别为32.56%,74.42%,61.90%和25.58%。使用四格表检验,Survivin蛋白胞浆检出:OR=3.38,95%CI(0.99~11.52),P=0.044;P53:OR=3.91,P=0.005;Survivin和P53并联:OR=10.66,P=0.0087。按照病理分级分层,P53:OR=3.41,P=0.016;P53和Survivin蛋白联合应用:OR=8.86,P=0.022。结论:肿瘤组织中P53蛋白的过度表达提示膀胱移行细胞癌复发风险较高,但是仍需要和其他生物学指标联合应用。更多还原

【Abstract】 BACKGROUND & AIM: To explore the correlation between up-regulated expressions of Survivin and P53 proteins in the tumor tissues and relapse of transitional cell carcinoma (TCC) of the bladder. MATERIALS AND METHODS: Survivin and P53 proteins in the paraffin-embedded tumor tissues derived from 75 cases of TCC were examined by immunohistochemical staining. The expressions of the two proteins and the pathological grading were assessed, using Mantel-Haenszel analysis to calculate the odds ratios and significance level for difference of the indicators between the relapse and non-relapse groups of the TCC patients. RESULTS: The positive staining rates of Survivin in cytoplasm, Survivin in nuclei, P53, and cytoplasmic Survivin plus P53 were 76.0% , 30.67% , 53.33% and 84.0% , respectively. The sensitivity for predicting the relapse were 87.50% , 37.50% , 71.88% and 96.88% , respectively. The specificities were 32.56% , 74.42% , 61.90% and 25.58% , respectively. The relative risks for the relapse were as following, Survivin (cytoplasm): OR=3.38, 95% CI (0.99- 11.52), P=0.044; P53: OR=3.91, 95% CI (1.46- 10.45), P=0.005; Survivin plus P53: OR=10.66, P=0.0087. The odds ratios by pathological grading classification were, P53: OR=3.41, P=0.016; P53 plus Survivin: OR=8.86, P=0.022. CONCLUSION: Over-expression of P53 protein in the tumor tissues might suggest a high risk for recurrence of bladder TCC, whereas the association between overexpression of Survivin and relapse of TCC was not demonstrated.更多还原