联合检测Survivin与Egr-1在食管鳞癌中的表达及临床意义

董晓刚 皮芹 安外尔约 .麦尔阿卜拉 郭文佳

[摘要] 目的 探討Survivin和Egr-1在食管鳞癌组织和正常食管组织中的表达情况，分析Survivin和Egr-1与食管鳞癌临床病理特征和预后的相关性。方法 采用免疫组织化学染色方法检测2012年1月—2014年6月方便收集的80例食管鳞癌组织和20例正常食管组织中Survivin和Egr-1的蛋白表达水平，统计分析Survivin和Egr-1与临床病理特征和生存预后之间的关系。结果 Survivin在食管鳞癌组织中阳性表达率为68.8%（55/80），高于在正常组织中的阳性表达率5.0%（1/20）（χ2=26.39，P<0.05）。Egr-1在食管鳞癌中的低表达率为66.3%（53/80），高于正常组织中的15.0%（3/20）（χ2=17.06，P<0.05）。Survivin蛋白在食管鳞癌中阳性高表达与患者的性别、年龄以及肿瘤的分化程度，差异无统计学意义（P>0.05），与食管鳞癌患者TNM分期、肿瘤的浸润深度、肿瘤大小以及淋巴结是否转移，差异有统计学意义（P<0.05）。Egr-1蛋白在食管鳞癌中阳性低表达与患者性别、肿瘤大小以及肿瘤浸润深度，差异无统计学意义（P>0.05），与食管鳞癌患者年龄、TNM分期、肿瘤分化程度以及淋巴结是否转移，差异有统计学意义（P<0.05）。随访结果显示食管鳞癌患者5年生存率为48.9%，中位生存时间为53.1个月。结论 Survivin和Egr-1在食管鳞癌的发生发展中起重要作用，联合检测两者对判断食管鳞癌的预后有一定的指导意义，Survivin和Egr-1有望作为食管鳞癌的治疗或者预后预测靶标。

[关键词] Survivin;Egr-1;食管鳞癌;免疫组化

[Abstract] Objective To investigate the expression of Survivin and Egr-1 in esophageal squamous cell carcinoma tissues and normal esophageal tissues， and to analyze the correlation between Survivin and Egr-1 and the clinicopathological characteristics and prognosis of esophageal squamous cell carcinoma. Methods The expression levels of Survivin and Egr-1 in 80 esophageal squamous cell carcinoma tissues and 20 normal esophageal tissues conveniently collected from January 2012 to June 2014 were detected by immunohistochemical staining. Survivin and Egr-1 were statistically analyzed. Relationship with clinicopathological characteristics and survival prognosis. Results The positive expression rate of Survivin in esophageal squamous cell carcinoma was 68.8% （55/80）， which was higher than that in normal tissues 5.0%/（1/20）（χ2=26.39， P<0.05）. The low expression rate of Egr-1 in esophageal squamous cell carcinoma was 66.3% （53/80）， which was higher than 15.0% （3/20） in normal tissues（χ2=17.06， P<0.05）. The positive expression of Survivin protein in esophageal squamous cell carcinoma was not significantly different from the patient's gender， age， and tumor differentiation（P>0.05）. It was different from TNM staging， tumor invasion depth， tumor size， and lymph nodes in patients with esophageal squamous cell carcinoma. The difference was statistically significant（P<0.05）. There was no statistically significant difference between the positive expression of Egr-1 protein in esophageal squamous cell carcinoma and the patient's gender， tumor size， and depth of tumor invasion（P>0.05）. It was different from the age， TNM stage， tumor differentiation， and lymph nodes of patients with esophageal squamous cell carcinoma. The difference was statistically significant（P<0.05）. The follow-up results showed that the 5-year survival rate of patients with esophageal squamous cell carcinoma was 48.9%， and the median survival time was 53.1 months. Conclusion Survivin and Egr-1 play an important role in the occurrence and development of esophageal squamous cell carcinoma. The combined detection of both has certain guiding significance for judging the prognosis of esophageal squamous cell carcinoma. Survivin and egr-1 are expected to be therapeutic or prognostic targets for esophageal squamous cell carcinoma.

Survivin和Egr-1与肿瘤的关系较为复杂，二者与癌基因和抑癌基因的关系、对ESCC中靶基因调节的分子机制等尚未研究清楚，国内外对二者与放射诱导后相关基因表达变化以及对放射敏感性的影响研究也较少，对这些问题的不断深入研究和解决将有助于对ESCC个体化诊治起到基础理论作用。该研究运用免疫组化的方法联合检测ESCC中Survivin和Egr-1的表达情况，后期还可以尝试联合检测Survivin和Egr-1蛋白在ESCC患者血清中与组织中的表达，考察其是否可以成为ESCC新的肿瘤标记物，为ESCC的早期诊断提供新的方法。

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