Clinical Significance Of Survivin And Multiple Factors In Prognosis Of Bladder Urothelial Carcinoma

Objective:To detect the relationships between the expression of survivin in bladder urothelial carcinoma tissue and cancer-specific survival by immunohistochemistry. And to blot the risk factors by analysis potentially risk factors which can result in cancer-specific death, to provide individual schedule for patients'follow-up and treatment.Methods:Collect bladder urothelial carcinoma patients'information who underwent operation including gender, age, disease category (the initial, the recrudescent, the multiple recrudescent),tumor sharp, tumor number(single, multiple), tumor size, tumor grade, tumor stage, operation mode (TURBT, partial cystectomy, cystectomy). Detect the expression of survivin in the paraffin block of bladder urothelial carcinoma patients and follow up the survival time and conditions of recurrence. Utilize Kaplank-Meier survival curve and Logrank analysis to estimate the relationships between the expression of survivin in bladder urothelial carcinoma tissue and cancer-specific survival. Utilize the regression analysis to analyze multiple factor and to establish prognosis index (PI) model according to the analytic result.Results:Cancer-specific survival was shorter in those patients with survivin positive compared with those with survivin negative (P=0.001< 0.05); patients'age (RR=1.116, P=0.002), tumor stage (RR=4.963, P=0.000) and disease category (RR=2.698, P=0.015) were independently associated with poorer cancer-specific survival in bladder urothelial carcinoma patients. To divide patients into high risk class, midrange risk class and low risk class according to numerical value of PI. There was statistical significance among the three classes'survival median time (P=0.000< 0.05).their survival median time respectively were 52,48,10 months.Conclusion:1. Survivin express has limited prognostic value in patients with bladder urothelial carcinoma, overall survival was shorter in those patients with survivin positive compared with those survivin negative.2. Age, tumor stage, disease category and tumor number were independently associated with poorer cancer-specific survival.3. The difference of prognosis index has statistical significance in patients with bladder urothelial carcinoma. The higher the prognosis index is, the shorter the survival time is. It is beneficial to detect these risk factors for follow-up of patients' prognosis and choice of individual treatment schedule.