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目的:探讨Survivin在Dukes’C期结直肠癌中的表达情况及其对辅助化疗疗效的预测作用。方法:应用免疫组化法检测85例根治性术后,行标准辅助化疗的Dukes’C期结直肠癌患者的癌组织和14例正常结直肠组织中Survivin的表达,分析与临床病理因素的相关性,并进行生存分析。结果:肿瘤组织Survivin阳性率为51.76%,正常组织中无Survivin表达,两组阳性率差异有显著性(P<0.05)。Survivin的表达与患者的年龄、性别、病程、肿瘤部位、肿瘤最大径、大体类型、组织分型、分化程度、肠壁浸润深度、淋巴结转移部位之间均无显著相关性(P均>0.05)。Survivin蛋白的表达与肿瘤的复发转移显著相关,Survivin阳性者复发转移率54.52%,显著高于Survivin阴性者(26.83%)(P=0.009)。Survivin阳性患者3年、5年无病生存率和总生存率显著低于阴性患者,Cox模型多因素分析,Survivin是影响肿瘤复发转移和生存的独立的预后因素。结论:Survivin在Dukes’C期结直肠癌中表达上调,与辅助化疗的疗效相关,可作为预测辅助化疗疗效的分子指标。
Objective: To investigate the expression of Survivin in Dukes’C stage colorectal cancer and its predictive value of adjuvant chemotherapy. Methods: The expression of Survivin in 85 cases of Dukes’C stage colorectal cancer patients and 14 cases of normal colorectal cancer patients undergoing radical operation and standard adjuvant chemotherapy were detected by immunohistochemistry, and the correlations with clinicopathological factors were analyzed Sex, and survival analysis. Results: The positive rate of Survivin in tumor tissue was 51.76%, while there was no expression of Survivin in normal tissues. There was significant difference between the two groups (P <0.05). There was no significant correlation between the expression of Survivin and the age, sex, course of disease, tumor location, maximum diameter of tumor, gross type, histological type, differentiation degree, depth of intestinal wall invasion and lymph node metastasis (all P> 0.05) . The expression of Survivin protein was significantly associated with tumor recurrence and metastasis. The recurrence and metastasis rate of Survivin positive was 54.52%, which was significantly higher than that of Survivin negative (26.83%) (P = 0.009). Survivin positive patients 3 years, 5-year disease-free survival rate and overall survival rate was significantly lower than negative patients, Cox model multivariate analysis, Survivin is an independent prognostic factor affecting tumor recurrence, metastasis and survival. Conclusion: Survivin is up-regulated in Dukes’C stage colorectal cancer, which is correlated with the curative effect of adjuvant chemotherapy and can be used as a molecular index to predict the effect of adjuvant chemotherapy.