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目的检测胃癌患者外周血中生存素(Survivin)基因的表达,并分析其与诊断、转移之间的关系,探讨其作为无创性胃癌诊断和预后检测指标的可能性。方法取52例胃癌患者(转移30例,未转移22例),48例癌前病变患者和50例健康成人的外周血,用实时定量RT-PCR法检测Survivin基因的表达,并分析其与临床病理因素之间的关系。结果正常对照组外周血中未检测到Survivin mRNA表达。48例癌前病变患者中8例被检测到有Survivin mRNA表达,平均拷贝数为1.70±0.75;胃癌组患者Survivin表达检测率为88.46%(46例),平均拷贝数为5.81±1.77,两者有显著差异(P<0.01)。有淋巴结或其他脏器转移者,以及低分化型组的胃癌患者的Survivin表达明显增高(P<0.05)。生存分析表明,Survivin mRNA的高表达者5年生存率(58.33%)显著低于低表达者(89.29%)(P<0.05)。回归分析发现,淋巴结转移、Survivin mRNA的高表达,是影响胃癌预后的独立因素。结论Survivin基因在胃癌患者中存在过表达,并与胃癌预后不良的病理学参数相关,Survivin基因检测可作为临床诊断和评估胃癌患者预后的客观指标之一。采用实时定量RT-PCR检测外周血中Survivin基因的表达,可能是一种较理想的无创性胃癌诊断、转移检测方法。
Objective To detect the expression of Survivin gene in peripheral blood of gastric cancer patients and to analyze its relationship with the diagnosis and metastasis and to explore the possibility of Survivin as a diagnostic and prognostic indicator of gastric cancer. Methods Survivin gene expression was detected by real-time quantitative RT-PCR in 52 cases of gastric cancer (30 cases with metastasis, 22 cases without metastasis), 48 cases with precancerous lesions and 50 cases with healthy adults. The relationship between pathological factors. Results Survivin mRNA expression was not detected in peripheral blood of normal control group. Survivin mRNA expression was detected in 8 out of 48 precancerous lesions with an average copy number of 1.70 ± 0.75. Survivin expression was detected in 88.46% (46 cases) of gastric cancer patients with an average copy number of 5.81 ± 1.77 There was a significant difference (P <0.01). Survivin expression was significantly increased in patients with lymph node or other organ metastases and poorly differentiated gastric cancer (P <0.05). Survival analysis showed that the 5-year survival rate (58.33%) of survivin mRNA overexpression was significantly lower than that of low expression (89.29%) (P <0.05). Regression analysis found that lymph node metastasis, high expression of Survivin mRNA is an independent factor affecting the prognosis of gastric cancer. Conclusion Survivin gene is overexpressed in gastric cancer patients and is associated with poor prognosis of gastric cancer. Survivin gene detection may be used as an objective indicator in clinical diagnosis and prognosis of gastric cancer patients. Using real-time quantitative RT-PCR to detect the expression of Survivin gene in peripheral blood may be an ideal method for the diagnosis and metastasis of non-invasive gastric cancer.