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目的分析生存素(survivin)在细胞核、细胞质中的表达与脑胶质瘤患者各临床病理学参数及预后的关系。方法应用组织芯片技术结合免疫组织化学方法检测94例胶质瘤患者中survivin 蛋白质细胞核、细胞质的表达情况,并结合临床随访资料进行分析。结果 94例胶质瘤患者中有21例(22.3%)为 survivin 细胞核阳性表达,82例(87.2%)为 survivin 细胞质阳性表达。病理Ⅰ～Ⅱ级与Ⅲ～Ⅳ级的 survivin 细胞核阳性表达率分别为7.3%、34.0%(P<0.01);复发与无复发胶质瘤的 survivin 细胞核阳性表达率分别为29.8%、10.8%(P<0.05)。survivin 细胞核表达阳性组与阴性组的5年总生存率分别为0%、39.50%(P<0.01),3年无进展生存率分别为0%、27.52%(P<0.05);survivin 浆表达阳性组与阴性组的5年总生存率分别为43.60%、13.85%(P>0.05),3年无进展生存率分别为23.88%、0%(P>0.05)。多因素分析显示:survivin 细胞核表达是总生存率的独立预后因子。结论 survivin 细胞核表达与胶质瘤分化程度呈负相关,是胶质瘤患者总生存率和无进展生存率预后的不利因素;而 survivin 细胞质表达与胶质瘤的预后无关。
Objective To analyze the relationship between the expression of survivin in nucleus and cytoplasm and the clinicopathological parameters and prognosis of patients with glioma. Methods Tissue microarray and immunohistochemistry were used to detect the expression of survivin protein in nucleus and cytoplasm of 94 glioma patients. The data were analyzed with clinical follow-up data. Results Totally 21 (22.3%) of 94 glioma patients were positive for survivin nuclei and 82 (87.2%) were positive for survivin cytoplasm. The positive expression rates of survivin nuclei in pathological grade Ⅰ ~ Ⅱ and grade Ⅲ ~ Ⅳ were 7.3% and 34.0%, respectively (P <0.01). The positive rates of survivin in recurrence and non-recurrence glioma were 29.8% and 10.8% P <0.05). The 5-year overall survival rates of survivin-positive and -negative groups were 0% and 39.50%, respectively (P <0.01). The 3-year progression-free survival rates were 0% and 27.52% The 5-year overall survival rates were 43.60% and 13.85% respectively in the group and the negative group (P> 0.05). The 3-year progression-free survival rates were 23.88% and 0% respectively (P> 0.05). Multivariate analysis showed that survivin nuclear expression was an independent prognostic factor for overall survival. Conclusions There is a negative correlation between the expression of survivin and the differentiation degree of glioma, which is the unfavorable factor of prognosis of patients with glioma. The expression of survivin in the cytoplasm has nothing to do with the prognosis of glioma.