Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
Pediatr Hematol Oncol. 2022 Feb;39(1):16-27. doi: 10.1080/08880018.2021.1931588. Epub 2021 Jun 2.
Survivin is an inhibitor of apoptosis protein that inhibits caspases and blocks cell death. It is undetectable in most normal adult tissues. High survivin expression has been detected in various tumors and has been correlated with therapy resistance and poor outcome. We conducted this study to examine survivin expression in pediatric Ewing sarcoma (ES) and evaluate its role in predicting clinical outcome. Formalin-fixed paraffin-embedded tumor tissues from 108 pediatric ES patients were examined by immunostaining with survivin rabbit monoclonal antibodies. Survivin was detected in tumor tissues of 72 (66.7%) patients. High expression (≥50%) was detected in 18 (16.7%) patients. High survivin expression was shown to be a significant univariate parameter for poorer overall (OS) and event free survival (EFS) with p value 0.033, and 0.037 respectively. It was confirmed as an independent factor in multivariate analysis for OS (p: 0.041; HR: 1.97 with 95% CI of 1.03-3.79) and EFS (p: 0.049; HR: 1.86 with 95% CI of 1.00-3.46). These results suggest that high survivin expression identifies a group of patients with poor prognosis and this may help to refine risk adapted treatment; however, this needs to be confirmed in prospective studies.
生存素是一种凋亡抑制蛋白，能抑制半胱氨酸蛋白酶并阻止细胞死亡。在大多数正常成人组织中无法检测到。在各种肿瘤中都检测到高表达的生存素，并与治疗耐药性和不良预后相关。我们进行这项研究，旨在检测小儿尤文肉瘤（ES）中的生存素表达，并评估其在预测临床结局中的作用。使用生存素兔单克隆抗体通过免疫染色法检测了 108 例小儿 ES 患者的福尔马林固定石蜡包埋肿瘤组织。在 72 例（66.7%）患者的肿瘤组织中检测到生存素。在 18 例（16.7%）患者中检测到高表达（≥50%）。高生存素表达被证明是总体生存（OS）和无事件生存（EFS）的显著单因素参数，p 值分别为 0.033 和 0.037。在多因素分析中，它被确认为 OS（p：0.041；HR：1.97，95%CI：1.03-3.79）和 EFS（p：0.049；HR：1.86，95%CI：1.00-3.46）的独立因素。这些结果表明，高生存素表达可识别预后不良的患者群体，这可能有助于制定风险适应治疗；然而，这需要在前瞻性研究中得到证实。
