Over-expression of survivin and VEGF in small-cell lung cancer may predict the poorer prognosis
Over-expression of survivin and VEGF in small-cell lung cancer may predict the poorer prognosis
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DOI：
10.1007/s12032-013-0775-5
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发表时间：
2014-01-01
期刊：
影响因子：
3.4
通讯作者：
Hou, Mei
中科院分区：
文献类型：
--
作者：
Chen, Ping;Zhu, Jiang;Hou, Mei
凋亡抑制因子Survivin在大多数肿瘤中均有表达，并与血管生成因子血管内皮生长因子（VEGF）密切相关。但对它们在小细胞肺癌（SCLC）中的作用知之甚少。本研究旨在探讨Survivin和VEGF在小细胞肺癌中的表达及其与临床病理特征和预后的关系。45例病理组织学为SCLC的患者进入本研究。同时选取45例配对的肺旁非肿瘤标本和10例肺良性肿瘤手术标本作为对照。免疫组化（IHC，SP）法检测Survivin和VEGF的表达。对这两组数据进行处理，并检验其与主要患者特征和总生存率的相关性。采用卡方检验分析Survivin和VEGF表达与临床病理特征的相关性。采用斯皮尔曼秩相关检验分析Survivin与VEGF表达的相关性，Kaplan-Meier法分析总生存期，考克斯比例风险模型分析临床病理特征与总生存期的关系。Survivin和VEGF在小细胞肺癌中的阳性表达率分别为73.3vs.15.6vs.0%（P < 0.05）和75.6vs.20vs.0%（P <0.05），明显高于癌旁组织和肺良性肿瘤组织（P < 0.05）。Survivin和VEGF的表达与淋巴结转移（P = 0.003，0.011）和临床分期（P = 0.006，0.021）相关。Survivin与VEGF的表达呈显著正相关（r = 0.644，P = 0.000）。Survivin阳性组和VEGF阳性组的中位总生存期分别显著短于Survivin阴性组和VEGF阴性组（log-rank P = 0.000）。多因素分析显示，Survivin（HR 0.224; 95% CI 0.074-0.675; P = 0.008）和VEGF（HR 0.172; 95% CI 0.054-0.559; P = 0.003）是SCLC患者预后不良的独立预测因素。本研究结果提示Survivin和VEGF在小细胞肺癌中过度表达，它们可能是影响小细胞肺癌预后的独立因素。
The expression of survivin, an inhibitor of apoptosis can be seen in most tumors and is correlated with the angiogenic factor vascular endothelial growth factor (VEGF). But little is known about their contribution in small-cell lung cancer (SCLC). This study was designed to investigate the expression of survivin and VEGF in SCLC, and to explore their correlation with clinical-pathological feature and prognosis. Forty-five patients with pathological histology of SCLC were entered into this study. Forty-five cases of matched adjacent non-tumor samples and 10 samples of operated patients with benign lung tumor were also included as control. The expression of survivin and VEGF was detected by immunohistochemistry (IHC, SP). These two sets of data were processed and tested for correlation with major patients' characteristics, and overall survival. The correlations between survivin and VEGF expressions and the clinical-pathological features were evaluated by chi-square test. The correlation between survivin and VEGF expressions was analyzed by Spearman's rank correlation test; the overall survival was analyzed by the Kaplan-Meier method; and the relationship between clinical and pathological features and overall survival was analyzed by the Cox proportional hazard models. Positive expression rate of survivin and VEGF was significantly higher in SCLC than those of adjacent non-tumor tissues and benign lung tumor tissues (73.3 vs. 15.6 vs. 0 %, P < 0.05) and (75.6 vs. 20 vs. 0 %, P < 0.05), respectively. Survivin and VEGF expressions were significantly associated with lymph node metastasis (P = 0.003, 0.011) and clinical stage (P = 0.006, 0.021). The expression of survivin was significantly coincident with the expression of VEGF (r = 0.644, P = 0.000). The median overall survival in survivin positive group and VEGF positive group was significantly shorter than those in survivin negative and VEGF negative group, respectively (log-rank P = 0.000). Moreover, multivariate analysis showed that survivin expression (HR 0.224; 95 % CI 0.074-0.675; P = 0.008) and VEGF expression (HR 0.172; 95 % CI 0.054-0.559; P = 0.003) were statistically independent predictive factors of poorer prognosis for SCLC patients. Our results indicated that survivin and VEGF were over-expressed in small-cell lung cancer, each of them may be an independent poor prognostic factor.