Fan Yibing, Chen Juan
a Department of Obstetrics and Gynecology , The Fifth Clinical Medical College of Yangzhou University, the Second People's Hospital of Obstetrics and Gynecology of Changshu City , Changshu , China.
b Department of Gynecology , GongLi Hospital Affiliated of the Second Military Medical University , Shanghai , China.
Bioengineered. 2017 Sep 3;8(5):511-523. doi: 10.1080/21655979.2016.1252879. Epub 2017 Jan 4.
Survivin has been shown to play an important role in cancer pathogenesis. However, its role in cervical cancer development is still controversial. This study was performed to evaluate the clinical significance of survivin expression in cervical cancer.
Search of some online electronic databases was conducted to identify available studies. The pooled odds ratios (ORs) with its 95% confidence intervals (CIs) were calculated and analyzed.
Finally, 18 eligible studies with 791 cervical cancer patients, 1,013 cervical intraepithelial neoplasia (CIN) lesions, 199 normal cervical tissues, and 95 samples with chronic cervicitis were identified in this analysis. The pooled OR of survivin expression was found to be significantly higher in the samples from cervical cancer than in those from CIN lesions, normal cervical tissues, and chronic cervicitis. When cervical cancer was compared to CIN lesions, the subgroup analysis by ethnicity showed that survivin expression was associated with a risk of cervical cancer in Asians (P < 0.001), but not in Caucasians (P = 0.659). In addition, survivin was significantly more overexpressed in high-grade cervical cancer than in low-grade cervical cancer. Its expression was also more elevated in advanced-stage patients than in early-stage patients, in lymph node metastasis than in lymph node without metastasis, and in squamous cell carcinoma (SCC) than in adenocarcinoma (AC).
The expression of survivin may play a key role in the carcinogenesis, progression, and metastasis of cervical cancer. However, survivin expression may be involved in the progression of CIN lesions only in the Asian population. Survivin expression is associated with an increased risk of SCC. Additional studies with larger sample sizes are needed in the future to confirm our findings.
Survivin已被证明在癌症发病机制中起重要作用。然而，其在宫颈癌发生发展中的作用仍存在争议。本研究旨在评估Survivin表达在宫颈癌中的临床意义。
检索一些在线电子数据库以识别可用研究。计算并分析合并比值比（OR）及其95%置信区间（CI）。
本分析最终确定了18项符合条件的研究，涉及791例宫颈癌患者、1013例宫颈上皮内瘤变（CIN）病变、199例正常宫颈组织和95例慢性宫颈炎样本。发现宫颈癌样本中Survivin表达的合并OR显著高于CIN病变、正常宫颈组织和慢性宫颈炎样本中的OR。当将宫颈癌与CIN病变进行比较时，按种族进行的亚组分析表明，Survivin表达与亚洲人患宫颈癌的风险相关（P < 0.001），而在白种人中则无相关性（P = 0.659）。此外，Survivin在高级别宫颈癌中的过表达明显高于低级别宫颈癌。其在晚期患者中的表达也高于早期患者，在有淋巴结转移的患者中高于无淋巴结转移的患者，在鳞状细胞癌（SCC）中高于腺癌（AC）。
Survivin的表达可能在宫颈癌的发生、发展和转移中起关键作用。然而，Survivin表达可能仅在亚洲人群中参与CIN病变的进展。Survivin表达与SCC风险增加相关。未来需要更多大样本研究来证实我们的发现。
