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目的探讨胃癌组织中凋亡抑制因子survivin的表达及其与各临床病理因素的关系,评价survivin在胃癌预后判断中的价值。方法应用免疫组织化学EnVision两步法检测140例胃癌组织中survivin的表达情况,回顾性分析survivin与各临床病理因素及预后之间的关系。结果胃癌组织中survivin表达阳性率为46.4%(65/140)。累及浆膜层的胃癌survivin表达阳性率(53.2%)明显高于未及浆膜层者(32.6%),TNM分期Ⅲ、Ⅳ期的胃癌survivin表达阳性率(55.2%)明显高于Ⅰ、Ⅱ期者(38.4%)(P均<0.05)。分化较差的胃癌survivin表达阳性率(52.2%)与分化较好者差异无显著性意义(35.4%,P=0.059)。survivin表达阳性患者5年生存率(34.4%)明显低于表达阴性者(58.6%,P<0.006)。Cox回归模型分析显示,survivin表达状态是胃癌根治术后独立的预后因素,阳性表达提示预后不良。结论凋亡抑制因子survivin在胃癌组织中具有较高的表达率,其表达与胃癌的浸润深度和TNM分期相关。survivin的表达状态是胃癌根治术后独立的预后因素,阳性表达提示预后不良。
Objective To investigate the expression of survivin and its relationship with clinicopathological parameters in gastric cancer and evaluate the value of survivin in the prognosis of gastric cancer. Methods The expression of survivin in 140 cases of gastric carcinoma was detected by immunohistochemistry EnVision two-step method. The relationship between survivin and clinicopathological factors and prognosis was retrospectively analyzed. Results The positive rate of survivin in gastric cancer tissues was 46.4% (65/140). The positive rate of survivin expression in gastric cancer (53.2%) involving serosa was significantly higher than that in those without serosa (32.6%). The positive rates of survivin expression in gastric cancer with stage Ⅲ and Ⅳ TNM were 55.2% (38.4%) (all P <0.05). The poorly differentiated gastric cancer survivin expression positive rate (52.2%) and well differentiated with no significant difference (35.4%, P = 0.059). The 5-year survival rate (34.4%) of survivin positive patients was significantly lower than that of negative ones (58.6%, P <0.006). Cox regression analysis showed that the expression of survivin was an independent prognostic factor after radical operation of gastric cancer, and the positive expression suggested that the prognosis was poor. Conclusion The expression of survivin, a inhibitor of apoptosis, has a high expression rate in gastric cancer. The expression of survivin is correlated with the depth of invasion and the TNM stage of gastric cancer. The expression of survivin is an independent prognostic factor after radical operation of gastric cancer. The positive expression of survivin suggests that the prognosis is poor.