Relationship Between Survivin-expression And Its Subcellular Localization And The Prognosis Of Breast Cancer

Objective: Breast cancer is the most common malignancy among wo-men and second most common cause of cancer death after lung.Develo-pment of breast cancer is controlled by a balance between cell prolifer-ation and apoptosis.Survivin a multifunctional protein that controls celldivision,inhibition of apoptosis and promotion of angiogenesis.It is expr-essed in most human neoplasm,for example,breast cancer,gastric tumors,prostate cancer,lung cancer,bladder cancer,lymphoma,and so on.butis abs-entin normal and differ-entiated tissues.To detect the expression of Sur-vivin and its Subcellular localization in breast cancer and in57case ofthe breast carcinoma organizes and Survivin in20case of nomal breasttissues,analyzing the prognosis relevance with the union integrity clinica-lmaterial,to provide certain theory basis for breast cancer patient's diagn-osis and the prognosis judgment.Methods:Expression of Survivin was tested by immunohistochemicalmethod SP in57cases of breast carcinoma and Survivin in20case ofnomal breast tissues.The expression of Survivin and Subcellular localiza-tion of its in breast cancer with lymph node metastasis,tumor size,histology graduation,age,clinical stage,hormone acceptor situation and survivialtime were analyzed statistically using SPSS13.0software.Results:1.Expression of Survivin in breast carcinoma and nomal brea-st tissues:The expression rate of Survivin was68.4%(39/57) in breast c-ancer that was obviously higher than5%(2/40) in normal breast tissues.Statistical significance can be found between them(P<0.05);Positive expr-ession of survivin was mainly detected in cell cytoplasm and/or nucleusof breast cancer,and the positive rates were33.3%(19/57),19.3%(11/57),15.8%(9/57),49.1%(28/57) and35.1%(20/57) in cytoplasm only,in nucleu sonly,both in cytoplasm and nucleus,in cytoplasm,and in nucleus,respectively.Statistical significance can be not found between cytoplasm and nucleus(P＞0.05).The expression rate of Survivin in cytoplasm and in nucleus was obviously higher than that in normal breast tissues.Statistical significance can be found between them(P<0.05)。2.Correlation between Survivin and the clinical parameters of breastCarcinoma:The positive expressions of Survivin protein in breast cancerwas not related tumor size,tumor stage and age of patient(P＞0.05).Theexpression rate of survivin was81.5%in the tumor≥3cm group thatwas obviously higher than56.7%in the tumor＜3cm group.Statistical significance can be found between them (P<0.05).The expression rate ofSurvivin was84%in the lymph node metastasis that was obviously hi-gher than56.3%in the non-lymph node metastasis group.Statistical significance can be found between them(P<0.05).Nucleus-positive expressionsof Survivin protein in breast cancer was not related age of patient,tum-or size,lymph node metastasis and stage(P＞0.05).Cytoplasm-positive expressions of Survivin protein in breast cancer were not related and ageof patient(P＞0.05),but were associated with tumor size(33.3%V66.7%),lymph node metastasis(25%V84%)and tumor stage(46.2%V76.7%V71.4%)(P<0.05). Positive expression of ER and PR was all detected in cell nucleus of breast cancer,and the expression rate of ER was68.4%(39/57)in breast cancer in this study,and PR was61.4%(35/57).The positive expressions of ER and PR in breast cancer were not related age of patient,tumor size,stage and lymph node metastasis(P＞0.05).3.Correlation between survivin and its subcellular expression and ER,PR inbreast carcinoma3.1Correlation between survivin and ER,PR in breast carcinoma:The expression of Survivin in ER-negative breast carcinoma was significantlyhigher than that in ER-positive breast carcinoma(P<0.05),There were ne-gative correlations between Survivin and ER/PR.The correlation coefficient were-0.299and-0.306. 3.2Correlation between subcellular expression of survivin and ER,PRin breast carcinoma:Comparison between groups,statistical significancecannot be found between nuclear-positive expression and cytoplasm-positiveexpression of Survivin protein in ER/PR groups(P<0.05).Within group comparisons,survivin was mainly expressed in cytoplasm,but statistical si-gnifycance can not be found between nuclear-positive expression and cytoplasm-positive expressions of Survivin protein in ER-negative groups(P＞0.05).There was not statistical significance between nuclear-positive expression and cytoplasm-positive expressions of Survivin protein in ER-positive groups(P＞0.05).And there was not statistical significance between nuclear-positive expression and cytoplasm-positive expressions of Survivin protein in PR groups(P＞0.05).4.The relationship between survival time of breast cancer patient andthe expression of Survivin and subcellular localization: In the follow-upof41patients,survival37cases,death four people.The expression Survivin positive25cases. With the statistics of thedata,the three-year total survival rate was90.2%(37/41),and mortality rate was9.8%(4/41).And thethree-year survival rate in survivin-positive breast carcinoma was87.1%(27/31).The three-year survival rate in survivin-negative breast carcinoma was100%(10/10).The three-year survival rate was87%(20/23) in excessive expression(2+and3+) of Survivin and94.4%(17/18) in low andnegative expression(1+and-) of Survivin.There were not statistics significance between the difference(P＞0.05).The excessive expression of Survivin in cytoplasm was not associated with the survival rate in breast cancer and nuclear-positive expression was also too(P＞0.05).The Cox regression analysis to the clinical and pathologicalfeatures and Survivin express status and breast cancer patients total survival time relationship ofstatistical analysis,and the results show that the clinical stages,have without lymph node metastasis is decided to breastcancer patients total survival time of independent factors (P value were0.005;0.023,and0.003), and the expression of the total situation and Survivin survival time independent (P=0.356).Conclusion:1.Survivin was low expressed in nomal breast tissues and high expressed in breast cancer;The positive expression of Survivin protein in breast cancer was related tumor size and lymph node metastasis2.Cytoplasm-positive expressions of Survivin protein in breast cancerwere associated with tumor size,lymph node metastasis and tumorstage.prognosis of Cytoplasm-positive expressions of Survivin protein waspoor.3.There were negative correlations between Survivin and ER/PR.Theexpression of Survivin in grope of resistance of endocrine therapy washigher,Survivin is likely to predict endocrine therapeutic effect of breastcancer have certain effect.4.Survivin expression and subcellular localization in breast cancer prognosis of judge may have had some effect.