Department of Oral and Maxillofacial Plastic Surgery, Martin-Luther-University Halle- Wittenberg, Halle, Germany.
BMC Cancer. 2010 Feb 24;10:65. doi: 10.1186/1471-2407-10-65.
Survivin, a member of the inhibitor of apoptosis-protein family suppresses apoptosis and regulates cell division. It is strongly overexpressed in the vast majority of cancers. We were interested if survivin detected by immunohistochemistry has prognostic relevance especially for patients of the two soft tissue sarcoma entities leiomyosarcoma and synovial sarcoma.
Tumors of leiomyosarcoma (n = 24) and synovial sarcoma patients (n = 26) were investigated for their expression of survivin by immunohistochemistry. Survivin expression was assessed in the cytoplasm and the nucleus of tumor cells using an immunoreactive scoring system (IRS).
We detected a survivin expression (IRS > 2) in the cytoplasm of 20 leiomyosarcomas and 22 synovial sarcomas and in the nucleus of 12 leiomyosarcomas and 9 synovial sarcomas, respectively. There was no significant difference between leiomyosarcoma and synovial sarcoma samples in their cytoplasmic or nuclear expression of survivin. Next, all sarcoma patients were separated in four groups according to their survivin expression in the cytoplasm and in the nucleus: group 1: negative (IRS 0 to 2); group 2: weak (IRS 3 to 4); group 3: moderate (IRS 6 to 8); group 4: strong (IRS 9 to 12). In a multivariate Cox's regression hazard analysis survivin expression detected in the cytoplasm or in the nucleus was significantly associated with overall survival of patients in group 3 (RR = 5.7; P = 0.004 and RR = 5.7; P = 0.022, respectively) compared to group 2 (reference). Patients whose tumors showed both a moderate/strong expression of survivin in the cytoplasm and a moderate expression of survivin in the nucleus (in both compartments IRS > or = 6) possessed a 24.8-fold increased risk of tumor-related death (P = 0.003) compared to patients with a weak expression of survivin both in the cytoplasm and in the nucleus.
Survivin protein expression in the cytoplasma and in the nucleus detected by immunohistochemistry is significantly associated with prognosis of leiomyosarcoma and synovial sarcoma patients.
生存素是凋亡抑制蛋白家族的一员，它抑制细胞凋亡并调节细胞分裂。它在绝大多数癌症中过表达。我们感兴趣的是免疫组织化学检测到的生存素是否具有预后相关性，特别是对于两种软组织肉瘤（平滑肌肉瘤和滑膜肉瘤）患者。
通过免疫组织化学检测 24 例平滑肌肉瘤和 26 例滑膜肉瘤患者的生存素表达。使用免疫反应评分系统（IRS）评估肿瘤细胞的细胞质和细胞核中的生存素表达。
我们在 20 例平滑肌肉瘤和 22 例滑膜肉瘤的细胞质中检测到生存素表达（IRS>2），在 12 例平滑肌肉瘤和 9 例滑膜肉瘤的细胞核中检测到生存素表达。在细胞质或细胞核中表达生存素的平滑肌肉瘤和滑膜肉瘤样本之间没有显著差异。接下来，根据细胞质和细胞核中生存素的表达，将所有肉瘤患者分为四组：组 1：阴性（IRS0-2）；组 2：弱阳性（IRS3-4）；组 3：中度（IRS6-8）；组 4：强阳性（IRS9-12）。在多变量 Cox 回归风险分析中，在细胞质或细胞核中检测到的生存素表达与组 3患者的总生存率显著相关（RR=5.7；P=0.004 和 RR=5.7；P=0.022），与组 2（参考）相比。在细胞质和细胞核中均显示生存素中度/强表达（两个部位 IRS≥6）的肿瘤患者与在细胞质和细胞核中均显示弱表达生存素的肿瘤患者相比，肿瘤相关死亡的风险增加了 24.8 倍（P=0.003）。
免疫组织化学检测到的细胞质和细胞核中的生存素蛋白表达与平滑肌肉瘤和滑膜肉瘤患者的预后显著相关。
