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背景与目的:分析膀胱移行细胞癌肿瘤组织中Survivin和P53蛋白的表达情况,并探讨它们与肿瘤复发的关系。材料与方法:应用免疫组织化学方法检测75例膀胱移行细胞癌石蜡包埋肿瘤组织中Survivin和P53蛋白的表达。并按照患者临床病理级别分层,使用Mantel_Haenszel等统计学方法分析上述两种蛋白的表达与膀胱癌复发的相对危险度及显著性水平。结果:膀胱癌组织Survivin蛋白在胞浆、胞核检出率和P53蛋白的阳性检出率分别为76.0%、30.7%和53.33%;Survivin(胞浆)与P53并联使用阳性检出率为84.0%。以Survivin蛋白的胞浆、胞核的表达和P53蛋白表达、以及二者并联使用预测膀胱癌复发的灵敏度分别为87.50%、37.50%、71.88%和96.88%;特异度分别为32.56%,74.42%,61.90%和25.58%。使用四格表检验,Survivin蛋白胞浆检出:OR=3.38,95%CI(0.99~11.52),P=0.044;P53:OR=3.91,P=0.005;Survivin和P53并联:OR=10.66,P=0.0087。按照病理分级分层,P53:OR=3.41,P=0.016;P53和Survivin蛋白联合应用:OR=8.86,P=0.022。结论:肿瘤组织中P53蛋白的过度表达提示膀胱移行细胞癌复发风险较高,但是仍需要和其他生物学指标联合应用。
BACKGROUND & AIM: To analyze the expression of Survivin and P53 protein in bladder transitional cell carcinoma and to explore their relationship with tumor recurrence. MATERIAL AND METHODS: Survivin and P53 protein expression in paraffin-embedded tumor tissue of 75 cases of transitional cell carcinoma of the bladder was detected by immunohistochemistry. The patients were stratified according to the clinicopathological grade. Mantel_Haenszel and other statistical methods were used to analyze the relative risk and significance of bladder cancer recurrence and the expression of these two proteins. Results: The detection rates of Survivin protein in cytoplasm, nucleus and P53 protein in bladder cancer were 76.0%, 30.7% and 53.33%, respectively. The positive rate of Survivin (cytoplasm) in parallel with P53 was 84.0 %. The sensitivity of Survivin protein in cytoplasm, nucleus and P53 protein expression, and the parallel use of the two in predicting the recurrence of bladder cancer were 87.50%, 37.50%, 71.88% and 96.88%, respectively. The specificity were 32.56% and 74.42% , 61.90% and 25.58% respectively. Survivin protein cytoplasm was detected by four-cell table. OR = 3.38,95% CI (0.99 ~ 11.52), P = 0.044; P53: OR = 3.91, P = 0.005; = 0.0087. P53: OR = 3.41, P = 0.016. The combination of P53 and Survivin protein: OR = 8.86, P = 0.022. Conclusion: Overexpression of P53 protein in tumor tissue suggests that BTCC has a high risk of recurrent bladder cancer, but it still needs to be used in combination with other biological indicators.