Li Ming, Song Tao, Yin Zhen-fei, Na Yan-qun
Department of Urology, Peking University First Hospital, Beijing 100034, China.
Chin Med J (Engl). 2007 Mar 20;120(6):469-73.
Dysregulation of apoptosis has been implicated not only in carcinogenesis and tumor progression but also in tumor recurrence. We investigated whether the expression of X-linked inhibitor of apoptosis (XIAP) might predict early recurrence in patients with non-muscular invasive bladder cancer.
The cohort comprised 176 consecutive patients with primary superficial bladder cancer treated with transurethral resection. Immunohistochemical staining using the standard avidin-biotin-peroxidase technique and RT-PCR were used to detect XIAP protein and mRNA expressions in cancer tissues. The relationship between XIAP expression and clinicopathological characteristics, cancer recurrence were analyzed.
XlAP expression was observed in 108 cases (61.4%) and no expression in 68. There was no correlation between XIAP expression rate and the tumor pathological grade, but was an apparent trend toward the increased XIAP levels from well (G1) to poor (G3) differentiated cancer. Eighty-two (46.6%) patients experienced tumor recurrence at a mean of 28.6 months of the follow-up; 66 of them expressed XIAP (61.1%) and 16 were XIAP negative (23.5%). Twelve patients presented with invasive disease at the time of relapse and all of them expressed XIAP. Patients without XIAP expression or with low tumor grades had significantly higher recurrence-free survival than those with XIAP expression (log rank test P = 0.0015) or high tumor grades (log rank test P < 0.001). Multivariate analysis revealed that XIAP expression, tumor grade, and tumor number were independent predictors for the recurrence of non-muscular invasive bladder cancer (P = 0.004, 0.016, and 0.043, respectively).
XIAP may be considered as a new independent prognostic marker for early recurrence of non-muscular invasive bladder cancer.
细胞凋亡失调不仅与癌症的发生、发展有关，还与肿瘤复发相关。我们研究了X连锁凋亡抑制蛋白（XIAP）的表达是否可预测非肌层浸润性膀胱癌患者的早期复发。
该队列包括176例接受经尿道切除术治疗的原发性浅表性膀胱癌患者。采用标准的抗生物素蛋白-生物素-过氧化物酶技术进行免疫组织化学染色及逆转录-聚合酶链反应（RT-PCR）检测癌组织中XIAP蛋白和mRNA表达。分析XIAP表达与临床病理特征、癌症复发之间的关系。
108例（61.4%）观察到XIAP表达，68例无表达。XIAP表达率与肿瘤病理分级无相关性，但从高分化（G1）到低分化（G3）癌，XIAP水平有明显升高趋势。82例（46.6%）患者在平均随访28.6个月时出现肿瘤复发；其中66例表达XIAP（61.1%），16例XIAP阴性（23.5%）。12例患者复发时出现浸润性疾病，均表达XIAP。无XIAP表达或肿瘤分级低的患者无复发生存率显著高于有XIAP表达者（对数秩检验P = 0.0015）或肿瘤分级高者（对数秩检验P < 0.001）。多因素分析显示，XIAP表达、肿瘤分级和肿瘤数量是非肌层浸润性膀胱癌复发的独立预测因素（P分别为0.004、0.016和0.043）。
XIAP可被视为非肌层浸润性膀胱癌早期复发的一个新的独立预后标志物。
