目的 观察以替吉奥为基础的新辅助化疗前后胃癌组织中 survivin 蛋白的表达水平，探讨 survivin 蛋白在进展期 胃癌的表达与胃癌新辅助化疗的关系。方法 对 60 例内镜诊断明确的进展期胃癌患者进行以替吉奥为基础的新辅助化疗及 化疗后的手术治疗，根据胃癌患者病理学改变对新辅助化疗后患者手术标本进行疗效判定，将病例分成化疗有效组和化疗 无效组。通过病理检测化疗前内镜诊断标本及新辅助化疗后手术切除组织后 survivin 的表达水平，进而分析化疗前后胃癌 组织中 survivin 蛋白表达与以替吉奥为基础的新辅助化疗效果的关系。结果 有效组病例新辅助化疗前 survivin 表达水平明 显低于无效组，差异有统计学意义（P ＜ 0.05）；新辅助化疗后所有病例 survivin 表达水平均较新辅助化疗前升高，差异 有统计学意义（P ＜ 0.05）；新辅助化疗后 survivin 表达变化值在有效组和无效组差异不具有统计学意义（P ＞ 0.05）。结 论 胃癌患者 survivin 低表达，可能是患者对以替吉奥为基础的化疗敏感，化疗疗效好，行以替吉奥为基础的新辅助化疗后 survivin 表达水平升高，可能与胃癌化疗耐药相关，可能降低化疗效果；检测 survivin 表达水平可帮助预测胃癌对以替吉奥 为基础的新辅助化疗的敏感性。

Objective To observe the expression of survivin in advanced gastric cancer before and after neoadjuvant chemotherapy based on S-1 (tegafur gimeracil oteracil potassium capsule), and to explore the relationship between the expression of survivin in advanced gastric cancer and neoadjuvant chemotherapy in gastric cancer. Methods 60 patients with advanced gastric cancer who received neoadjuvant chemotherapy based on S-1 and gastric cancer surgery were enrolled in the study. According to the pathological changes of gastric cancer patients, the curative effect of the patients after neoadjuvant chemotherapy was determined, and the patients were classified as chemo-effective and chemo-noneffective groups. Through dectecting the expression level of survivin in pathological examination of endoscopic diagnostic specimens before chemotherapy and surgical excision tissue with neoadjuvant chemotherapy, then the relationship between survivin expression in gastric cancer before and after neoadjuvant chemotherapy based on S-1 was analyzed. Results There was significant difference in the expression of survivin before neoadjuvant chemotherapy between the chemo-effective and the chemo-noneffective groups (P<0.05). After neoadjuvant chemotherapy based on S-1, the expression of survivin significantly increased in the gastric cancer tissue (P<0.05). The variation of survivin expression after neoadjuvant chemotherapy based on S-1 was not correlated between the chemo-effective and the chemo-noneffective groups (P>0.05). Conclusions The low expression of survivin in patients with gastric cancer may be sensitive to neoadjuvant chemotherapy based on S-1, the effect of chemotherapy is good, the increased expression of survivin after neoadjuvant chemotherapy based on S-1 may be associated with chemoresistance of gastric cancer, which may reduce the effect of chemotherapy; detecting the expression of survivin can help to predict the sensitivity of neoadjuvant chemotherapy based on S-1 for gastric cancer.