Division of Pulmonary Medicine, Chung Shan Medical University Hospital and School of Medicine, Chung Shan Medical University, Taiwan.
Jpn J Clin Oncol. 2010 Mar;40(3):234-40. doi: 10.1093/jjco/hyp151. Epub 2009 Nov 22.
The sensitivity of cytologic examination of pleural effusions is variable and not predictive of prognosis. Survivin is an inhibitor of apoptosis that may be a novel diagnostic/prognostic marker of cancers. This study aimed to determine the diagnostic and prognostic value of measuring survivin mRNA levels in pleural effusions.
Eighty-eight consecutive pleural effusion samples were examined for both cytology and survivin mRNA level. The accuracy of diagnosis and the correlation between survivin mRNA level and survival in malignant pleural effusion (MPE) were determined. Pleural effusions were divided into three groups: Group I, malignancy-associated (n = 44); Group II, inflammatory (n = 27); and Group III, transudative (n = 17).
Survivin mRNA levels in Group I (1.03 +/- 0.61, range 0-2.96) were significantly higher than those in Groups II (0.45 +/- 0.69, range 0-3.30) and III (0.08 +/- 0.22, range 0-0.71) (P < 0.001). Survivin mRNA level was significantly higher in MPE than in non-MPE. The cut-off value for survivin mRNA levels in pleural effusions was 0.074 for the diagnosis of malignancies, with sensitivity, specificity, and positive and negative predictive values of 96%, 45%, 45% and 96%, respectively. Survivin mRNA level in pleural effusions of cancer patients significantly correlated with poor survival.
Survivin mRNA level is significantly higher in MPEs. Over-expression of survivin mRNA correlates with poor prognosis in cancer patients.
胸腔积液细胞学检查的敏感性是可变的，不能预测预后。Survivin 是凋亡的抑制剂，可能是癌症的一种新的诊断/预后标志物。本研究旨在确定胸腔积液中 survivin mRNA 水平的测量在诊断和预后方面的价值。
连续 88 例胸腔积液标本同时进行细胞学和 survivin mRNA 水平检查。确定诊断的准确性以及 survivin mRNA 水平与恶性胸腔积液（MPE）患者生存之间的相关性。胸腔积液分为三组：组 I，与恶性肿瘤相关（n = 44）；组 II，炎症性（n = 27）；组 III，渗出性（n = 17）。
组 I（1.03 ± 0.61，范围 0-2.96）的 survivin mRNA 水平明显高于组 II（0.45 ± 0.69，范围 0-3.30）和组 III（0.08 ± 0.22，范围 0-0.71）（P < 0.001）。MPE 中的 survivin mRNA 水平明显高于非 MPE。胸腔积液中 survivin mRNA 水平的截断值为 0.074，用于诊断恶性肿瘤，其敏感性、特异性、阳性预测值和阴性预测值分别为 96%、45%、45%和 96%。癌症患者胸腔积液中的 survivin mRNA 水平与不良生存显著相关。
MPE 中 survivin mRNA 水平明显升高。survivin mRNA 的过度表达与癌症患者的不良预后相关。
