Zhang Yanping, Huang Deliang, Yu Guo
Department of Otolaryngology, General Hospital of Chinese PLA, Beijing, People's Republic of China.
Acta Otolaryngol. 2005 Dec;125(12):1345-50. doi: 10.1080/00016480510043963.
The inverse correlation found in this study between survivin expression and the level of spontaneous apoptosis in nasal and paranasal sinus carcinoma (NPSC) suggests that survivin may play an important role in the tumorigenesis of NPSC. Survivin expression may provide a novel predictive indicator for disease-free survival after surgical resection and postoperative radiochemotherapy in NPSC.
NPSC is the third commonest neoplasm in otolaryngology. Little is known about the distribution of inhibitors of apoptosis in NPSC and how they correlate with the prognoses of patients. The objectives of this study were to assess the protein expression of a new inhibitor of apoptosis, survivin, and its correlation with spontaneous apoptosis, tumor clinicopathological parameters and prognosis in NPSC.
A total of 48 patients (23 females, 25 males; age range 20-71 years) with NPSC treated by means of radical operations between 1991 and 2000 were studied retrospectively. Spontaneous apoptotic cells were visualized by means of terminal deoxynucleotide transferase-mediated dUTP nick-end labeling in combination with hematoxylin-eosin and propidium iodide staining. Immunohistochemistry using the streptavidin-peroxidase method was used to assess the expression of survivin.
Survivin expression was positive in 23/48 samples (47.92%) but no staining was present in normal tissues adjacent to the tumors. The expression of survivin correlated negatively with the apoptotic index (r = - 0.393; p = 0.006). Patients with positive expression of survivin had a lower apoptotic index than those with negative expression (p < 0.05). The expression of survivin in advanced-stage tumors (T3 + T4) was higher than that in early ones (T1 + T2) (p < 0.05). Patients with negative expression of survivin had a much better prognosis than those with positive expression (p = 0.0346). Multivariate analyses revealed that expression of survivin and histological type were independent prognostic factors for overall survival.
本研究发现鼻及鼻窦癌（NPSC）中生存素表达与自发凋亡水平呈负相关，提示生存素可能在NPSC的肿瘤发生中起重要作用。生存素表达可能为NPSC手术切除及术后放化疗后的无病生存提供一种新的预测指标。
NPSC是耳鼻喉科第三常见的肿瘤。关于NPSC中凋亡抑制因子的分布及其与患者预后的关系知之甚少。本研究的目的是评估一种新的凋亡抑制因子生存素的蛋白表达及其与NPSC中自发凋亡、肿瘤临床病理参数和预后的关系。
回顾性研究1991年至2000年间48例接受根治性手术治疗的NPSC患者（23例女性，25例男性；年龄范围20 - 71岁）。通过末端脱氧核苷酸转移酶介导的dUTP缺口末端标记结合苏木精 - 伊红和碘化丙啶染色观察自发凋亡细胞。采用链霉亲和素 - 过氧化物酶法免疫组化评估生存素的表达。
48个样本中有23个（47.92%）生存素表达呈阳性，但肿瘤邻近的正常组织中无染色。生存素表达与凋亡指数呈负相关（r = - 0.393；p = 0.006）。生存素表达阳性的患者凋亡指数低于阴性表达患者（p < 0.05）。晚期肿瘤（T3 + T4）中生存素的表达高于早期肿瘤（T1 + T2）（p < 0.05）。生存素表达阴性的患者预后明显好于阳性表达患者（p = 0.0346）。多因素分析显示生存素表达和组织学类型是总生存的独立预后因素。
