Ko Yoon Ho, Roh Sang-Young, Won Hye Sung, Jeon Eun Kyoung, Hong Sook Hee, Lee Myung Ah, Kang Jin Hyoung, Hong Young Seon, Kim Min Sik, Jung Chan-Kwon
Division of Oncology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, Catholic University, Gyeonggi-do, South Korea.
Head Neck Oncol. 2010 Oct 30;2:30. doi: 10.1186/1758-3284-2-30.
The expression of survivin, an inhibitor of apoptosis, in tumor cells is associated with poor clinical outcome for various cancers. We conducted this study to determine survivin expression in patients with adenoid cystic carcinoma (ACC) of the head and neck and to identify its clinical significance as a prognostic factor.
We performed immunohistochemical staining for survivin, p53, bcl-2 protein, and Ki-67 in formalin fixed, paraffin-embedded blocks from 37 cases of head and neck ACC. We also reviewed the patients' clinical records to determine the association of staining with clinical course.
Of the 37 cases of head and neck ACC, 31 (83.8%) were positive for cytoplasmic survivin expression, and 23 (62.2%) were positive for nuclear survivin expression. There was a significant association between nuclear survivin expression and bcl-2 (P = 0.031). A larger tumor was more commonly a survivin-positive tumor (cytoplasmic survivin, P = 0.043; nuclear survivin, P = 0.057). Median overall survival (OS) was significantly longer in patients not expressing nuclear survivin (P = 0.035). A multivariate analysis revealed that nuclear survivin expression significantly impacted OS (hazard ratio 8.567, P = 0.018) in addition to lymph node involvement (hazard ratio 7.704, P = 0.016).
The immunohistochemical expression of nuclear survivin has a prognostic impact in patients with head and neck ACC. These results suggest that nuclear survivin expression may be a useful biomarker for predicting prognosis in patients with head and neck ACC who were treated with surgical resection.
凋亡抑制因子survivin在肿瘤细胞中的表达与多种癌症的不良临床预后相关。我们开展本研究以确定头颈部腺样囊性癌（ACC）患者中survivin的表达情况，并确定其作为预后因素的临床意义。
我们对37例头颈部ACC的福尔马林固定、石蜡包埋组织块进行了survivin、p53、bcl-2蛋白和Ki-67的免疫组化染色。我们还查阅了患者的临床记录以确定染色与临床病程的相关性。
在37例头颈部ACC中，31例（83.8%）细胞质survivin表达呈阳性，23例（62.2%）细胞核survivin表达呈阳性。细胞核survivin表达与bcl-2之间存在显著相关性（P = 0.031）。较大的肿瘤更常见为survivin阳性肿瘤（细胞质survivin，P = 0.043；细胞核survivin，P = 0.057）。未表达细胞核survivin的患者中位总生存期（OS）显著更长（P = 0.035）。多因素分析显示，除淋巴结受累外（风险比7.704，P = 0.016），细胞核survivin表达显著影响OS（风险比8.567，P = 0.018）。
细胞核survivin的免疫组化表达对头颈部ACC患者的预后有影响。这些结果表明，细胞核survivin表达可能是预测接受手术切除治疗的头颈部ACC患者预后的有用生物标志物。
