Li Yu-Hong, Hu Chun-Fang, Shao Qiong, Huang Ma-Yan, Hou Jing-Hui, Xie Dan, Zeng Yi-Xin, Shao Jian-Yong
State Key Laboratory of Oncology in Southern China, Guangzhou 510060, PR China.
J Transl Med. 2008 Jan 3;6:1. doi: 10.1186/1479-5876-6-1.
Nasopharyngeal carcinoma (NPC) is one of the most common malignancies in southern China. The China 1992 TNM staging system has been widely used for prognosis prediction of NPC patients in China. Although NPC patients can be classified according to their clinical stage in this system, their prognosis may vary significantly.
280 cases of NPC with clinical follow-up data were collected and expressions of survivin and VEGF in tumor tissues were investigated by immunohistochemistry (IHC). Apoptosis index (AI) in 100 cases of NPC was detected by the TUNEL method.
Expression of survivin and VEGF were significantly associated with TNM stage, T-stage and metastasis of NPC. The patients with survivin and VEGF over-expression presented lower 5-year survival rate, as compared to those of low-expression (42.32% vs. 70.54%, 40.1% vs. 67.8%, respectively, P < 0.05), especially in advanced stage patients (36.51% vs. 73.41%, 35.03% vs. 65.22%, respectively, P < 0.05). The 5-year survival rate in NPC patients with survivin and VEGF dual over-expression was significantly lower than that of patients with dual low-expression (18.22% vs. 73.54%, respectively; P = 0.0003). Multivariate analysis indicated that both survivin and VEGF over-expression in NPC tumor tissues were strong independent factors of poor prognosis in NPC patients. The mean AI in the 39 survivin low-expression cases was 144.7 +/- 39.9, which was significantly higher than that in 61 survivin over-expression cases (111.6 +/- 39.8) (T test, P < 0.05).
Survivin and VEGF over-expression are independent prognostic factors for the patients with NPC. These results also suggest that tumor survivin and VEGF expressions are valuable prognostic markers for prognosis prediction in NPC patients.
鼻咽癌（NPC）是中国南方最常见的恶性肿瘤之一。1992年中国TNM分期系统已在中国广泛用于鼻咽癌患者的预后预测。尽管在此系统中鼻咽癌患者可根据其临床分期进行分类，但其预后可能有显著差异。
收集280例有临床随访数据的鼻咽癌病例，采用免疫组织化学（IHC）法检测肿瘤组织中生存素（survivin）和血管内皮生长因子（VEGF）的表达。采用TUNEL法检测100例鼻咽癌的凋亡指数（AI）。
生存素和VEGF的表达与鼻咽癌的TNM分期、T分期及转移显著相关。生存素和VEGF过表达的患者5年生存率低于低表达患者（分别为42.32%对70.54%，40.1%对67.8%，P<0.05），尤其是晚期患者（分别为36.51%对73.41%，35.03%对65.22%，P<0.05）。生存素和VEGF双过表达的鼻咽癌患者5年生存率显著低于双低表达患者（分别为18.22%对73.54%；P = 0.0003）。多因素分析表明，鼻咽癌肿瘤组织中生存素和VEGF过表达均是鼻咽癌患者预后不良的强独立因素。39例生存素低表达病例的平均AI为144.7±39.9，显著高于61例生存素过表达病例（111.6±39.8）（T检验，P<0.05）。
生存素和VEGF过表达是鼻咽癌患者的独立预后因素。这些结果还表明，肿瘤生存素和VEGF表达是鼻咽癌患者预后预测中有价值的预后标志物。
