Department of Radiotherapy and Oncology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
Radiat Oncol. 2012 Jun 14;7:88. doi: 10.1186/1748-717X-7-88.
To investigate the prognostic value of survivin expression in pretreatment specimens from patients with anal cancer treated with concurrent 5-FU and mitomycin C-based chemoradiation (CRT).
Immunohistochemical staining for survivin was performed in pretreatment biopsies of 62 patients with anal carcinoma. Survivin expression was correlated with clinical and histopathological characteristics as well as local failure free- (LFFS), distant metastases free- (DMFS), cancer specific- (CSS), and overall survival (OS).
Survivin staining intensity was weak in 10%, intermediate in 48% and intense in 42% of the patients. No association between survivin expression and clinicopathologic factors (tumor stage, age and HIV status) could be shown. In univariate analysis, the level of survivin staining was significantly correlated with DMFS (low survivin vs. high survivin: 94% vs. 74%, p = 0.04). T-stage, N-stage and the tumor grading were significantly associated with OS and CSS and with DMFS and LFFS, respectively. In multivariate analysis, survivin was confirmed as independent prognostic parameter for DMFS (RR, 0.04; p = 0.02) and for OS (RR, 0.27; p = 0.04).
Our results demonstrated that the level of pretreatment survivin is correlated with the clinical outcome in patients with anal carcinoma treated with concurrent CRT. Further studies are warranted to elucidate the complex role of survivin for the oncologic treatment and to exploit the protein as a therapeutic target in combined modality treatment of anal cancer.
研究同步 5-FU 和丝裂霉素 C 为基础的放化疗（CRT）治疗的肛门癌患者预处理标本中生存素表达的预后价值。
对 62 例肛门癌患者的预处理活检进行生存素免疫组织化学染色。生存素表达与临床和组织病理学特征以及局部无失败生存率（LFFS）、远处转移无复发生存率（DMFS）、癌症特异性生存率（CSS）和总生存率（OS）相关。
患者中 10%的生存素染色强度较弱，48%的生存素染色强度中等，42%的生存素染色强度较强。生存素表达与临床病理因素（肿瘤分期、年龄和 HIV 状态）之间无相关性。单因素分析显示，生存素染色水平与 DMFS 显著相关（低生存素 vs. 高生存素：94% vs. 74%，p=0.04）。T 分期、N 分期和肿瘤分级与 OS 和 CSS 以及 DMFS 和 LFFS 均显著相关。多因素分析证实，生存素是 DMFS（RR，0.04；p=0.02）和 OS（RR，0.27；p=0.04）的独立预后因素。
我们的结果表明，同步 CRT 治疗的肛门癌患者预处理生存素水平与临床结局相关。需要进一步研究以阐明生存素在肛门癌综合治疗中的复杂作用，并将该蛋白作为联合治疗的治疗靶点。
