CAJ | 학술논문

目的探讨术前动脉化疗栓塞对膀胱癌组织凋亡抑制基因Survivin表达的影响及其临床意义.方法对50例膀胱癌患者化疗栓塞前后的肿瘤组织,应用免疫组织化学法测定Survivin的表达,比较化疗栓塞前后膀胱癌组织中Survivin的表达程度,并分析Survivin与膀胱癌病理分级和临床分期的关系.结果 Survivin阳性表达率在化疗栓塞前随着肿瘤的病理分级、临床分期的升高而增加,差异有统计学意义(P＜0.05).化疗栓塞前后Survivin阳性表达率分别为72％(36/50),22％(11/50),差异有统计学意义(P＜0.01),高级别及T2～T4期Survivin阳性表达率在化疗栓塞后明显降低,差异有统计学意义(P＜0.01).经随访化疗栓塞后3年生存率Survivin阴性表达患者[94.87％(37/39)]高于阳性表达患者(7/11),但差异无统计学意义(P＞0.05).复发患者化疗栓塞后Survivin阳性表达率(5/8)明显高于无复发患者[5.56％(2/36)],差异有统计学意义(P＜0.01).结论术前化疗栓塞能降低膀胱癌组织Survivin的表达,调节膀胱癌的分化程度,使肿瘤降级降期,降低复发率.Survivin的表达可作为膀胱癌预后估计的指标.
목적 탐토술전동맥화료전새대방광암조직조망억제기인Survivin표체적영향급기림상의의.방법 대50례방광암환자화료전새전후적종류조직,응용면역조직화학법측정Survivin적표체,비교화료전새전후방광암조직중Survivin적표체정도,병분석Survivin여방광암병리분급화림상분기적관계.결과 Survivin양성표체솔재화료전새전수착종류적병리분급、림상분기적승고이증가,차이유통계학의의(P＜0.05).화료전새전후Survivin양성표체솔분별위72％(36/50),22％(11/50),차이유통계학의의(P＜0.01),고급별급T2～T4기Survivin양성표체솔재화료전새후명현강저,차이유통계학의의(P＜0.01).경수방화료전새후3년생존솔Survivin음성표체환자[94.87％(37/39)]고우양성표체환자(7/11),단차이무통계학의의(P＞0.05).복발환자화료전새후Survivin양성표체솔(5/8)명현고우무복발환자[5.56％(2/36)],차이유통계학의의(P＜0.01).결론 술전화료전새능강저방광암조직Survivin적표체,조절방광암적분화정도,사종류강급강기,강저복발솔.Survivin적표체가작위방광암예후고계적지표.
Objective To investigate the influence of preoperative arterial chemoembolization on the expression of Survivin,and study the clinical significance in bladder cancer.Methods The tissue before and after chemoembolization of 50 patients with bladder cancer were selected,the Survivin expression was examined by immunohistochemical method.The Survivin expression was compared between before and after chemoembolization in bladder cancer tissue,and the relation of its expression to the pathological grade and clinical stage was evaluated clinically.Results The positive rate of Survivin expression before chemoembolization raised with the rising of the pathological grade and clinical stage,there was statistical difference (P ＜ 0.05).The positive rate of Survivin expression before and after chemoembolization was 72％ (36/50) and 22％ (11/50),there was statistical difference (P ＜0.01).The positive rate of Survivin expression in high grade pathological grade and T2-T4 clinical stage after chemoembolization was significantly lower than that before chemoembolization,there was statistical difference (P ＜0.01).The survival rate 3 years after chemoembolization in Survivin negative expression patients was higher than that in Survivin positive expression patients [94.87％(37/39) vs.7/11],but there was no statistical difference (P ＞ 0.05).The Survivin positive expression in recurrence patients was significantly higher than that in non-recurrence patients [5/8 vs.5.56％ (2/36)],there was statistical difference (P ＜ 0.01).Conclusions Preoperative arterial chemoembolization can reduce the expression of Survivin,adjust malignancy of bladder cancer,could downgrade and downstage the tumor,reduce recurrence rate.The expression of Survivin can serve as predictive factor for prognosis of bladder cancer.