Abstract

Survivin is an inhibitor of apoptosis protein that inhibits caspases and blocks cell death. It is undetectable in most normal adult tissues. High survivin expression has been detected in various tumors and has been correlated with therapy resistance and poor outcome. We conducted this study to examine survivin expression in pediatric Ewing sarcoma (ES) and evaluate its role in predicting clinical outcome. Formalin-fixed paraffin-embedded tumor tissues from 108 pediatric ES patients were examined by immunostaining with survivin rabbit monoclonal antibodies. Survivin was detected in tumor tissues of 72 (66.7%) patients. High expression (≥50%) was detected in 18 (16.7%) patients. High survivin expression was shown to be a significant univariate parameter for poorer overall (OS) and event free survival (EFS) with p value 0.033, and 0.037 respectively. It was confirmed as an independent factor in multivariate analysis for OS (p: 0.041; HR: 1.97 with 95% CI of 1.03-3.79) and EFS (p: 0.049; HR: 1.86 with 95% CI of 1.00-3.46). These results suggest that high survivin expression identifies a group of patients with poor prognosis and this may help to refine risk adapted treatment; however, this needs to be confirmed in prospective studies.

摘要

Survivin 是一种凋亡蛋白抑制剂，可抑制半胱天冬酶并阻断细胞死亡。在大多数正常成人组织中检测不到。已在各种肿瘤中检测到高生存素表达，并且与治疗抗性和不良结果相关。我们进行了这项研究，以检查小儿尤文肉瘤 (ES) 中 survivin 的表达，并评估其在预测临床结果中的作用。通过用存活蛋白兔单克隆抗体进行免疫染色检查了来自 108 名小儿 ES 患者的福尔马林固定石蜡包埋的肿瘤组织。在 72 名 (66.7%) 患者的肿瘤组织中检测到 Survivin。在 18 名 (16.7%) 患者中检测到高表达 (≥50%)。高生存素表达被证明是较差的总体 (OS) 和无事件生存 (EFS) 的重要单变量参数，p 值分别为 0.033 和 0.037。它被确认为 OS（p：0.041；HR：1.97，95% CI 为 1.03-3.79）和 EFS（p：0.049；HR：1.86，95% CI 为 1.00-3.46）的多变量分析中的独立因素。这些结果表明，高生存素表达确定了一组预后不良的患者，这可能有助于改进风险适应治疗；然而，这需要在前瞻性研究中得到证实。