Samarkos Michael, Papaxoinis George, Athanasoula Kalliopi, Benopoulou Οlga, Bouros Spyros, Anastasopoulou Amalia, Diamantopoulos Panagiotis, Gogas Helen, Mantzourani Marina
First Department of Medicine, Laiko General Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
J BUON. 2018 Dec;23(7):96-103.
Survivin represents a key anti-apoptotic molecule that is highly expressed in the vast majority of tumors. The aim of the study was to examine the significance of survivin mRNA blood levels in melanoma patients.
In this prospective translational research study, survivin mRNA blood levels were measured in melanoma patients treated with adjuvant interferon or systemic treatment for advanced disease.
Sixty-four patients with melanoma and 40 healthy controls were included. The majority of them had tumor stages III and IV. The upper 95% confidence interval (95%CI) of survivin levels in controls was set as normal cut-off. Fifty-two (81.3%) patients had survivin levels above normal cut-off. Melanoma patients had higher survivin levels than controls (p<0.0001). Survivin levels were non-significantly higher in stage III compared to stage IV patients. Patients with survivin levels above vs. below median had median progression-free survival (PFS) 19.5 months vs. 7.4 months (p=0.045), but median overall survival (OS) not reached vs. 18.4 months (p=0.091). Cox proportional hazard models showed that only tumor stage was associated with PFS and OS. There was no statistically significant change in survivin levels between baseline and during treatment (p=0.845) or during follow-up (p=0.101).
Although melanoma patients had significantly higher survivin levels than controls, the study showed that survivin mRNA blood levels did not represent an independent prognostic factor for patients with melanoma. The role of circulating survivin should be further examined in larger studies.
生存素是一种关键的抗凋亡分子，在绝大多数肿瘤中高表达。本研究旨在探讨黑色素瘤患者血液中生存素mRNA水平的意义。
在这项前瞻性转化研究中，对接受辅助干扰素治疗或晚期疾病全身治疗的黑色素瘤患者进行了生存素mRNA血液水平检测。
纳入64例黑色素瘤患者和40例健康对照。他们大多处于肿瘤III期和IV期。将对照组生存素水平的95%置信区间上限设定为正常临界值。52例（81.3%）患者的生存素水平高于正常临界值。黑色素瘤患者的生存素水平高于对照组（p<0.0001）。III期患者的生存素水平略高于IV期患者，但差异无统计学意义。生存素水平高于中位数与低于中位数的患者，其无进展生存期（PFS）中位数分别为19.5个月和7.4个月（p=0.045），但总生存期（OS）中位数未达到与18.4个月（p=0.091）。Cox比例风险模型显示，只有肿瘤分期与PFS和OS相关。基线与治疗期间（p=0.845）或随访期间（p=0.101）生存素水平无统计学显著变化。
尽管黑色素瘤患者的生存素水平显著高于对照组，但本研究表明，血液中生存素mRNA水平并非黑色素瘤患者的独立预后因素。循环生存素的作用应在更大规模的研究中进一步探讨。
