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目的:探讨调亡抑制蛋白(XIAP)和细胞凋亡基因(Caspase-9)在喉鳞状细胞癌中的表达及与其临床病理特征和预后的关系。方法:采用免疫组织化学SP法检测75例喉鳞状细胞癌组织和4O例正常喉黏膜中XIAP与Caspase-9的表达,结合临床及随访资料进行分析XIAP与Caspase-9表达与喉癌临床病理特征及预后的关系。结果:喉癌组织中XIAP阳性表达率明显高于癌旁组织(P<0.01),Caspase-9阳性表达率明显低于正常喉黏膜组织(P<0.01)。XIAP的表达与喉癌TNM分期、淋巴结转移密切相关(P<0.01),而Caspase-9的表达与TNM分期、病理分级、淋巴结转移密切相关(P<0.01)。75例喉癌组织中XIAP蛋白的表达和Caspase-9蛋白的表达呈负相关(P<0.01)。XIAP表达阴性患者的5年生存率明显优于XIAP表达阳性的患者(P<0.01),而Caspase-9表达阳性患者的5年生存率明显优于Caspase-9表达阴性的患者(P<0.01)。Cox回归单因素分析显示淋巴结转移、病理分级、TNM分期、XIAP及Caspase-9表达与喉癌患者5年生存率明显相关(P<0.05)。Cox回归多因素分析表明淋巴结转移、XIAP及Caspase-9表达是喉癌患者5年生存率的独立预后因素(P<0.05)。结论:XIAP在喉癌组织中表达增高,而Caspase-9表达降低,两者表达均为影响喉癌预后的独立危险因素;XIAP可能对Caspase-9具有直接抑制作用,通过降低Caspase-9表达水平,从而发挥抑制癌细胞凋亡的作用。
Objective: To investigate the expression of XIAP and Caspase-9 in laryngeal squamous cell carcinoma and its relationship with clinicopathological features and prognosis. Methods: The expressions of XIAP and Caspase-9 in 75 cases of laryngeal squamous cell carcinoma and 40 cases of normal laryngeal mucosa were detected by immunohistochemical SP method. The clinical and follow-up data were used to analyze the correlation between the expression of XIAP and Caspase-9, Characteristics and prognosis of the relationship. Results: The positive rate of XIAP in laryngeal carcinoma was significantly higher than that in paracancerous tissues (P <0.01). The positive rate of Caspase-9 in laryngeal carcinoma was significantly lower than that in normal laryngeal mucosa (P <0.01). The expression of XIAP was closely related to TNM staging and lymph node metastasis (P <0.01), while Caspase-9 expression was closely related to TNM staging, pathological grade and lymph node metastasis (P <0.01). The expression of XIAP protein and Caspase-9 protein in 75 cases of laryngeal carcinoma were negatively correlated (P <0.01). The 5-year survival rate of XIAP-negative patients was significantly higher than that of XIAP-positive patients (P <0.01). The 5-year survival rate of patients with positive expression of Caspase-9 was significantly higher than that of patients with negative expression of Caspase-9 . Cox regression univariate analysis showed that lymph node metastasis, pathological grade, TNM stage, XIAP and Caspase-9 expression were significantly associated with 5-year survival rate of laryngeal cancer patients (P <0.05). Cox regression multivariate analysis showed that lymph node metastasis, XIAP and Caspase-9 expression were independent prognostic factors of 5-year survival rate of patients with laryngeal cancer (P <0.05). Conclusion: The expression of XIAP in laryngeal carcinoma increased, while the expression of Caspase-9 decreased, the expression of both was an independent risk factor for the prognosis of laryngeal carcinoma. XIAP may have a direct inhibitory effect on Caspase-9, by reducing the expression level of Caspase-9 , Which play a role in inhibiting cancer cells apoptosis.