论文部分内容阅读
目的:评价Survivin和COX-2在胰腺癌中的表达与预后的关系。方法:采用免疫组化二步法检测63例手术切除的原发性胰腺癌组织及11例癌旁非肿瘤胰腺组织中Survivin和COX-2的表达情况。应用Spearman相关分析Survivin与COX-2表达的相关性。用Kaplan-Meier法分析生存曲线,多变量Cox比例风险回归模型筛选影响患者生存的独立预后因素。结果:Survivin、COX-2蛋白在胰腺腺癌中的表达呈正相关(r=0.613,P=0.000)。Survivin阳性表达患者中位生存时间(9个月)明显小于阴性表达者中位生存时间(21个月),P=0.000;COX-2阳性表达患者中位生存时间(10个月)也明显小于阴性表达者生存时间(大于36个月),P=0.000;Survivin阴性/COX-2阴性组患者(9例)中位生存时间(大于36个月)及1年累计生存率为88.9%,均明显高于单一阳性表达或均阳性表达组。多因素分析(Cox模型)显示分化程度(P=0.002)、临床分期(P=0.000)及Survivin过表达(P=0.005)为影响胰腺癌预后的独立因素。结论:Survivin、COX-2蛋白在胰腺癌组织中表达上调且呈正相关,二者在胰腺癌的发生发展中可能具有协同作用,有望作为靶点用于胰腺癌的靶向治疗。患者的分化程度、临床分期及Survivin的表达水平是胰腺癌患者手术后生存的独立危险因素。
OBJECTIVE: To evaluate the relationship between the expression of Survivin and COX-2 in pancreatic cancer and its prognosis. Methods: The expressions of Survivin and COX-2 in 63 cases of primary pancreatic cancer and 11 cases of adjacent non-tumorous pancreatic tissue were detected by immunohistochemical two-step method. Correlation between Survivin and COX-2 expression using Spearman correlation analysis. Survival curves were analyzed by Kaplan-Meier method, and multivariate Cox proportional hazards regression model was used to screen for independent prognostic factors affecting patient survival. Results: The expression of Survivin and COX-2 protein in pancreatic adenocarcinoma was positively correlated (r = 0.613, P = 0.000). The median survival time (9 months) in patients with positive Survivin expression was significantly lower than that in negative patients (21 months), P = 0.000. The median survival time (10 months) in patients with positive COX-2 expression was also significantly lower than The median survival time (greater than 36 months) and the 1-year cumulative survival rate (88.9%) in the survivin negative / COX-2 negative group (9 patients) were Significantly higher than a single positive expression or positive expression group. Multivariate analysis (Cox model) showed that differentiation (P = 0.002), clinical stage (P = 0.000) and Survivin overexpression (P = 0.005) were independent prognostic factors for pancreatic cancer. CONCLUSIONS: Survivin and COX-2 proteins are up-regulated and positively correlated in pancreatic cancer tissues. Both of them may play synergistic roles in the development of pancreatic cancer and may serve as target for the targeted therapy of pancreatic cancer. The degree of differentiation, clinical stage and Survivin expression in patients with pancreatic cancer were independent risk factors for postoperative survival.