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目的探讨生存素(survivin)基因在胃癌组织中的表达及其与胃癌预后关系。方法病例来源于1995年7月至1996年6月中山医院住院手术患者,采用免疫组化Envision二步法检测手术切除的胃癌病灶组织中生存素基因表达。根据手术病理诊断与临床表现确定肿瘤TNM分期。所有病例随访至少5年或直到死亡。比较不同病理类型、不同TNM分期生存素表达差异。按生存素基因是否表达比较两组患者生存曲线的差异。结果共有96例患者进入研究和随访观察,其中男59例,女37例;年龄29～84岁,平均56岁,68例表达生存素基因产物,阳性率70.8%。病理类型中腺癌78例,非腺癌18例,不同病理类型生存素基因表达相似(腺癌69.7%、非腺癌60.0%,P=0.369)。对腺癌病例分析显示:低分化组生存素基因表达高于中高分化组(82.1%比62.5%,P=0.053);肿瘤累及固有肌层组和全层组生存素基因表达高于肿瘤局限于黏膜或黏膜下层组(81.3%,75.9%比33.3%,P=0.020)。生存素表达与淋巴结转移与否无关(68.1%比70.8%,P=0.771)。生存素阳性组5年生存率(42.93%)低于生存素阴性组(52.93%),但差异无统计学意义。结论生存素基因在胃癌中高表达。生存素基因表达与胃腺癌分化程度以及肿瘤累及深度有关,需进行更多研究评价其在预后中的作用。
Objective To investigate the expression of survivin gene in gastric cancer and its relationship with the prognosis of gastric cancer. Methods From July 1995 to June 1996, patients undergoing inpatient operation in Zhongshan Hospital were enrolled. Methods Envision immunohistochemistry was used to detect the expression of survivin genes in the surgically resected gastric cancer tissues. According to the pathological diagnosis and clinical manifestations of TNM staging. All cases were followed up for at least 5 years or until death. Compare different pathological types, different TNM staging of survivin expression differences. According to whether the expression of survivin gene expression difference between the two groups of patients survival curve. Results A total of 96 patients entered the study and follow-up observation, including 59 males and 37 females; aged 29-84 years (mean 56 years), 68 patients expressed survivin gene products with a positive rate of 70.8%. Pathological types of 78 cases of adenocarcinoma, non-adenocarcinoma in 18 cases, different pathological types of survivin gene expression similar (adenocarcinoma 69.7%, non-adenocarcinoma 60.0%, P = 0.369). The analysis of adenocarcinoma cases showed that the expression of survivin gene in poorly differentiated group was higher than that in moderately and well-differentiated group (82.1% vs 62.5%, P = 0.053) Mucosal or submucosal group (81.3%, 75.9% vs. 33.3%, P = 0.020). Survivin expression had no correlation with lymph node metastasis (68.1% vs 70.8%, P = 0.771). The 5-year survival rate of survivin positive group (42.93%) was lower than that of survivin negative group (52.93%), but the difference was not statistically significant. Conclusions Survivin gene is highly expressed in gastric cancer. Survivin gene expression and gastric adenocarcinoma differentiation and tumor depth, the need for more research to evaluate its role in the prognosis.