Survivin在T细胞非霍奇金淋巴瘤组织中的表达及临床意义

 【目的】了解生存蛋白Survivin在T细胞非霍奇金淋巴瘤（T—NHL）中的表达，以及Survivin表达与预后的关系。【方法】用免疫组化S-P法检测83例T细胞NHL组织Survivin表达情况，分析Survivin表达与预后的关系。【结果】Survivin表达阴性10例（12％），表达阳性73例（88％），Survivin表达与病理类型、性别、年龄、B症状、结外病变数、PS、分期、LDH水平、IPI等临床特征均无相关性（P〉0．05）。78例接受了化疗，大多数采用CHOP方案化疗，全组CR率45％，有效率86％，Survivin阴性者CR率60％，阳性者43％（P〉0．05）。中位随访22月（1—76月），全组5年生存率31％，Survivin表达阳性的T—NHL患者5年生存率明显低于Survivin表达阴性患者（21％比70％，P〈0．001）。多因素分析显示Survivin表达是T细胞NHL的独立预后指标。【结论】Survivin在T细胞NHL表达上调，Survivin阳性T—NHL患者5年生存率低于Survivin阴性者，Survivin表达可能为T细胞NHL预后的独立指标。

Clinical Significance of Survivin Expression in T-cell Non-Hodgkin's Lymphoma

Objectives] This study was designed to evaluate the expression of survivin in T-cell non-Hodgkin's lymphoma (T-NHL) and the correlation of survivin expression and prognosis. Methods] Expression of survivin in T-NHL tissues were detected by immunohistochemical staining (S-P method). The relationship between survivin expression and prognosis were analyzed among 83 patients. Results] Ten patients showed negative survivin expression (12%), Seventy-three showed positive survivin expression (88%). Survivin expression was not related to the pathological subtypes, stage, LDH, extranodal sites, B symptoms and IPI score in our study (P >0.05). Most of the patients were treated by combined chemotherapy (CHOP regimen). The overall response rate was 86% with 45% complete remission (CR) rates. The patients with positive survivin expression tend to be lower in CR rate (43% vs 60%, P >0.05). The 5-year overall survival for the patients with negative survivin expression was longer than that of the patients with positive survivin expression (21% vs 70%, P< 0.001). The results of multivariant analysis showed survivin was an independent prognostic factor for T-NHL. Conclusion] Up-regulation of survivin expression in T-NHL is observed in our study. The 5-year overall survival of the patients with positive survivin was shorter than that of the patients with negative survivin expression. Expression of survivin may be an independent prognostic factor for T-NHL based on our study.