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目的探讨检测外周血生存素(survivin)的表达与结肠癌复发、转移的关系。方法采用反转录-聚合酶链反应-酶联免疫吸附试验(RT-PCR-ELISA)方法检测结肠癌患者外周血中survivinmRNA的表达,分析其与临床病理因素之间的关系。对其中51例患者进行36个月随访,比较复发及转移时间与外周血中survivin mRNA表达之间的关系。结果 95例结肠癌患者中35例survivin mRNA表达阳性(36.8%)。肿瘤高中分化及低未分化患者survivin mRNA表达率分别为31.0%和45.0%(P<0.05),浸润深度达浆膜层者表达率为44.0%,高于侵及黏膜下层及肌层者(20.0%)(P<0.05),淋巴结有转移者表达率为47.5%,高于无淋巴结转移者(19.4%)(P<0.05)。随访发现外周血sur-vivin表达阳性患者的复发及转移率(47.3%)明显高于阴性患者(16.6%)。提示survivin mRNA在外周血的表达与肿瘤分化、浸润深度、淋巴结转移和临床分期有关,但与肿瘤部位无明显关系。结论外周血survivin阳性患者易于复发或转移;外周血survivin的表达可作为评价结肠癌生物学行为及预后的参考指标。
Objective To investigate the relationship between the expression of survivin in peripheral blood and the recurrence and metastasis of colon cancer. Methods The expression of survivin mRNA in peripheral blood of patients with colon cancer was detected by reverse transcription-polymerase chain reaction-enzyme-linked immunosorbent assay (RT-PCR-ELISA), and its relationship with clinicopathological factors was analyzed. Fifty-one patients were followed up for 36 months, and the relationship between the recurrence and metastasis time and the expression of survivin mRNA in peripheral blood was compared. Results 35 cases of 95 cases of colon cancer survivin mRNA expression was positive (36.8%). The positive rates of survivin mRNA expression in high-grade and low-grade non-differentiated tumors were 31.0% and 45.0%, respectively (P <0.05). The positive rate of survivin mRNA expression in serosal invasion was 44.0%, higher than that in submucosa and muscular %) (P <0.05). The positive rate of lymph node metastasis was 47.5%, higher than that of no lymph node metastasis (19.4%) (P <0.05). Follow-up showed that the recurrence and metastasis rate of patients with positive sur-vivin expression (47.3%) was significantly higher than that of negative patients (16.6%). It is suggested that the expression of survivin mRNA in peripheral blood is related to tumor differentiation, depth of invasion, lymph node metastasis and clinical stage, but not to the tumor site. Conclusion Survivin positive peripheral blood is prone to relapse or metastasis. The expression of survivin in peripheral blood can be used as a reference index to evaluate the biological behavior and prognosis of colon cancer.