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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
Objective: To investigate the changes of Survivin protein expression in esophageal cancer and its relationship with the prognosis of patients with esophageal cancer in Henan province. Methods: All 114 patients with esophageal cancer were residents of high incidence area, followed up for more than 5a. Survivin protein expression in cancer cells was detected by routine histopathology and immunohistochemistry (ABC). Results: The cytoplasm of Survivin was 67/114 (59%), the nucleus was 58/114 (51%), the cytoplasm was 24/114 (21%), 114 (11%) did not show any form of Survivin expression. The mean survival time and 95% confidence interval for survivin-positive and -negative patients with esophageal cancer were 38 (32.55) months and 57.7 (5.164) months, respectively. Survivin-positive patients (P <0.05). The mean survival time and 95% confidence interval of Survivin cytoplasmic expression group were 50 (4 4, 5 5) months, which were significantly lower than those of Survivin negative expression There was no significant difference in patients’ survival (P> 0.05). Sperman rank correlation analysis showed that Survivin nuclear positive expression was related to the depth of esophageal cancer cell invasion (P <0.05). The stepwise regression analysis of multivariate Cox model showed that “TNM staging”, “differentiation degree” and “Survivin nuclear expression ”The three factors have the greatest impact on patient survival. Conclusion: The positive expression of Survivin nucleus is a marker of poor prognosis in patients with esophageal cancer, which may serve as an independent prognostic indicator. Survivin protein cytoplasm expression has no correlation with the prognosis of patients with esophageal cancer