Wang Jianwen, Zhang Xiaodong, Wei Ping, Zhang Junhui, Niu Yinong, Kang Ning, Zhang Yuxiang, Zhang Weili, Xing Nianzeng
Division of Urology, Beijing ChaoYang Hospital, Capital Medical University, Beijing, 100020, China,
World J Urol. 2014 Dec;32(6):1477-84. doi: 10.1007/s00345-014-1246-0. Epub 2014 Mar 5.
To explore the potential correlation and prognostic value of Livin, Survivin and Caspase 3 expression in non-muscle-invasive bladder cancer (NMIBC).
We prospectively examined the simultaneous expression of Livin, Survivin and Caspase 3 with immunohistochemistry in the paraffin blocks of 138 patients who underwent transurethral resection, and ten cases of normal bladder specimens were studied as the control group. During a 48-month follow-up, clinical pathologic factors including gender, age, pathology stage, histology grade, adjuvant therapy and recurrence time were recorded. The curves for recurrence-free survival (RFS) were estimated by the Kaplan-Meier method, and the relationship between these proteins' expression and clinical pathologic factors was analyzed with the Cox regression model.
Livin and Survivin showed a high expression (H-exp) level of 65.22 and 71.01 % in NMIBC, respectively, whereas Caspase 3 expression level was 50.72 %, and H-exp level of Livin and Survivin were 72.7 and 80.0 % in pT1 stage, respectively, which were proved to be higher than that in pTa/Tis ratio (P < 0.05). The relation between the H-exp and low-expression (L-exp) groups of Livin and Survivin and RFS were found statistically significant (P < 0.05). Conversely, there was better RFS in H-exp Caspase 3 group than in L-exp group (P < 0.05). A risk score was developed on the basis of all three biomarkers to estimate the prognosis of NMIBC patients, and those expressing high Survivin and Livin and low Caspase 3 had a significant shorter RFS time (P < 0.05).
Livin, Survivin and Caspase 3 may be valuable as promising indicators of early recurrence in NMIBC.
探讨Livin、Survivin和Caspase 3在非肌层浸润性膀胱癌（NMIBC）中的潜在相关性及预后价值。
我们前瞻性地采用免疫组织化学方法检测了138例行经尿道切除术患者石蜡块中Livin、Survivin和Caspase 3的同时表达情况，并将10例正常膀胱标本作为对照组进行研究。在48个月的随访期间，记录包括性别、年龄、病理分期、组织学分级、辅助治疗及复发时间等临床病理因素。采用Kaplan-Meier法估计无复发生存（RFS）曲线，并通过Cox回归模型分析这些蛋白表达与临床病理因素之间的关系。
Livin和Survivin在NMIBC中的高表达（H-exp）水平分别为65.22%和71.01%，而Caspase 3的表达水平为50.72%；在pT1期，Livin和Survivin的H-exp水平分别为72.7%和80.0%，均高于pTa/Tis期（P<0.05）。Livin和Survivin的H-exp组与低表达（L-exp）组与RFS之间的关系具有统计学意义（P<0.05）。相反，Caspase 3的H-exp组的RFS优于L-exp组（P<0.05）。基于这三种生物标志物建立了一个风险评分系统来评估NMIBC患者的预后，那些高表达Survivin和Livin且低表达Caspase 3的患者RFS时间明显缩短（P<0.05）。
Livin、Survivin和Caspase 3可能作为NMIBC早期复发的有价值的预测指标。
