Abstract
BackgroundNasopharyngeal carcinoma (NPC) is one of the most common malignancies in southern China. The China 1992 TNM staging system has been widely used for prognosis prediction of NPC patients in China. Although NPC patients can be classified according to their clinical stage in this system, their prognosis may vary significantly.Method280 cases of NPC with clinical follow-up data were collected and expressions of survivin and VEGF in tumor tissues were investigated by immunohistochemistry (IHC). Apoptosis index (AI) in 100 cases of NPC was detected by the TUNEL method.ResultsExpression of survivin and VEGF were significantly associated with TNM stage, T-stage and metastasis of NPC. The patients with survivin and VEGF over-expression presented lower 5-year survival rate, as compared to those of low-expression (42.32% vs. 70.54%, 40.1% vs. 67.8%, respectively, P < 0.05), especially in advanced stage patients (36.51% vs. 73.41%, 35.03% vs. 65.22%, respectively, P < 0.05). The 5-year survival rate in NPC patients with survivin and VEGF dual over-expression was significantly lower than that of patients with dual low-expression (18.22% vs. 73.54%, respectively; P = 0.0003). Multivariate analysis indicated that both survivin and VEGF over-expression in NPC tumor tissues were strong independent factors of poor prognosis in NPC patients. The mean AI in the 39 survivin low-expression cases was 144.7 ± 39.9, which was significantly higher than that in 61 survivin over-expression cases (111.6 ± 39.8) (T test, P < 0.05).ConclusionSurvivin and VEGF over-expression are independent prognostic factors for the patients with NPC. These results also suggest that tumor survivin and VEGF expressions are valuable prognostic markers for prognosis prediction in NPC patients.
Highlights
Inhibition of apoptosis may be involved in the pathogenesis of cancer by prolonging cell life and facilitating retention of deleterious mutations
Survivin and VEGF over-expression are independent prognostic factors for the patients with Nasopharyngeal carcinoma (NPC). These results suggest that tumor survivin and VEGF expressions are valuable prognostic markers for prognosis prediction in NPC patients
206 cases of the NPC patients were adequate for the final analysis. 74 cases were excluded from this study because of inadequate survivin staining
Summary
Inhibition of apoptosis may be involved in the pathogenesis of cancer by prolonging cell life and facilitating retention of deleterious mutations. Increased survivin expression has been observed in the most common human neoplasm, including oesophageal cancer [6], ovarian carcinoma[7], laryngeal squamous cell carcinoma [8], colorectal carcinoma [5], breast carcinoma[9] and lymphoma[10]. Most of these studies have demonstrated a positive correlation between survivin expression and poor prognosis of the disease, where a multivariate statistical analysis has revealed that survivin expression is an independent prognostic factor for disease progression[6,10,11,12]. NPC patients can be classified according to their clinical stage in this system, their prognosis may vary significantly
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