XIAP as a prognostic marker of early recurrence of nonmuscular invasive bladder cancer
XIAP as a prognostic marker of early recurrence of nonmuscular invasive bladder cancer
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DOI：
10.1097/00029330-200703020-00007
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发表时间：
2007-03-20
影响因子：
6.1
通讯作者：
Na Yan-qun
中科院分区：
文献类型：
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作者：
Li Ming;Song Tao;Na Yan-qun
细胞凋亡的失调不仅与肿瘤的发生和进展有关，而且与肿瘤复发有关。我们研究了X-linked inhibitor of apoptosis （XIAP）的表达是否可以预测非肌性浸润性膀胱癌患者的早期复发。方法对176例经尿道膀胱切除术治疗的原发性浅表性膀胱癌患者进行回顾性分析。采用标准亲和素-生物素-过氧化物酶技术和RT-PCR免疫组化染色检测癌组织中XIAP蛋白和mRNA的表达。分析XIAP表达与临床病理特征、肿瘤复发的关系。结果XIAP表达108例（61.4%），未表达68例（61.4%）。XIAP表达率与肿瘤病理分级无相关性，但从分化良好（G1）到分化不良（G3）有明显的升高趋势。82例（46.6%）患者在平均28.6个月的随访期间出现肿瘤复发；其中表达XIAP的66例（61.1%），XIAP阴性的16例（23.5%）。12例复发时出现侵袭性疾病的患者均表达XIAR，未表达XIAP或肿瘤分级低的患者的无复发生存率明显高于XIAP表达（log rank检验P=0.0015）或肿瘤分级高（log rank检验P < 0.001）的患者。多因素分析显示，XIAP表达、肿瘤分级和肿瘤数量是非肌性浸润性膀胱癌复发的独立预测因子（P值分别为0.004、0.016和0.043）。结论XIAP可作为非肌性浸润性膀胱癌早期复发的独立预后指标。
Background Dysregulation of apoptosis has been implicated not only in carcinogenesis and tumor progression but also in tumor recurrence. We investigated whether the expression of X-linked inhibitor of apoptosis (XIAP) might predict early recurrence in patients with non-muscular invasive bladder cancer.Methods The cohort comprised 176 consecutive patients with primary superficial bladder cancer treated with transurethral resection. Immunohistochemical staining using the standard avidin-biotin-peroxidase technique and RT-PCR were used to detect XIAP protein and mRNA expressions in cancer tissues. The relationship between XIAP expression and clinicopathological characteristics, cancer recurrence were analyzed.Results XIAP expression was observed in 108 cases (61.4%) and no expression in 68. There was no correlation between XIAP expression rate and the tumor pathological grade, but was an apparent trend toward the increased XIAP levels from well (G1) to poor (G3) differentiated cancer. Eighty-two (46.6%) patients experienced tumor recurrence at a mean of 28.6 months of the follow-up; 66 of them expressed XIAP (61.1%) and 16 were XIAP negative (23.5%). Twelve patients presented with invasive disease at the time of relapse and all of them expressed XIAR Patients without XIAP expression or with low tumor grades had significantly higher recurrence-free survival than those with XIAP expression (log rank test P=0.0015) or high tumor grades (log rank test P < 0.001). Multivariate analysis revealed that XIAP expression, tumor grade, and tumor number were independent predictors for the recurrence of non-muscular invasive bladder cancer (P=0.004, 0.016, and 0.043, respectively).Conclusions XIAP may be considered as a new independent prognostic marker for early recurrence of non-muscular invasive bladder cancer.