| Objective:To investigate the relationship between the expression of survivin /cox-2 and the clinicopathological features in colorectal carcinoma, and evaluate its significance in predicting the prognosis.Materials and Methods:Materials: specimens form 126 patients with advanced colorectal cancer without haematogenous metastasis receiving radical surgical treatment at the Department of General Surgery, Zhujiang hospital of the First Military Medical University, in the period 1992-2000, were evaluated. The clinical pathologic dates included age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis and Dukes classification, the time of post-operative local recurrence or haematogenous metastasis. In all these patients, the depth of tumor invasion was proper muscle or subserosa. The median follow-up period was 60 months(range 7- 98). Methods: In this study, using Tissue chip and immunohistochemistry methods by SABC, we examined Survivin and COX-2 expression in 126 patients with advanced human colorectal cancer, retrospectively analysis the relationship between Survivin/COX-2 and clinicopathological features and prognosis.Result:In all cases, Survivin and COX-2 expression were predominantly localized in tumor cells, whereas some stromal cells, endothelial cells, and colonic normalmucosa adjacent to the cancer tissue stained weakly. In cancer cells, Survivin and COX-2 expression were observed mainly in the cytoplasm and nuclear envelope. The patients were divided into low- and high-Survivin groups according to the grade and extent of Survivin expression by image analysis system of computer. High-Survivin expression was observed in 26(20.4%) cases and low-Survivin expression was observed in 100(79.6%) cases. And high-COX-2 expression was observed in 32(25.4%) cases, low-COX-2 expression was observed in 94(74.6%) cases.There was no significant correlation between Survivin or COX-2 expression and age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis and Dukes classification. However, high Survivin or high COX-2 expression was strongly correlated with tumor recurrence, especially haematogenous metastasis(P < 0.05). The survival rate without tumor recurrence for high- and low-Survivin groups was assessed by the Kaplan-Meier method and compared by log-rank test. The disease-free survival rate was significantly different between the two groups (P=0.0051). As the same methods, the disease-free survival rate was significantly different between the two groups (P=0.0067) of COX-2 expression. The results of multivariate analysis for all patients among the 8 prognostic factors(age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis and Dukes stage, and Survivin/COX-2 expression), Dukes stage Survivin and COX-2 expression may be recognized as the independent significant factor related to disease-free survival. Expression of Surviving and COX-2 were related positively in human colorectal cancer tissue. Low-Survivin expression in all cases , the COX-2 expression has the same tendency.Conclusion:1 Tissue microarray reveals characteristics of rapidness, convenience, economy and accuracy in large-scale application.2 Expression of Survivin was strongly correlated with tumor recurrence in colorectal cancer, especially haematogenous metastasis. Survivin expression was recognized as the independent significant factor related tothe prognosis.3 COX-2 expression significantly correlated with tumor recurrence in colorectal cancer, especially haematogenous metastasis. COX-2 was the independent significant factor related to the prognosis.4 These results suggest that a selective COX-2 inhibitor can be a novel class of therapeutic agents for haematogenous metastasis of colorectal cancer. The study have provided a scientific experiments evidence for selectively COX-2 inhibitors to be used to clinic.5 Expression of Surviving and COX-2 were related positively in human colorectal cancer tissue. There may be existed the...
|
PDF Full Text Request