Expression of Survivin and Its significance as prognostic factor in colorectal cancer

Abstract

Background: The surviving protein is expressed highly in most human tumors and fetal tissue, but is completely absent in terminally differentiated cell. Survivin is involved in both the control of cell division and the inhibition of apoptosis. The regulation of apoptotic cell death may have a profound effect on the pathogenesis and progression of colorectal cancer. This study examined the expression of in normal colorectal tissue and in colorectal cancer tissue and to determine whether the expression of survivin is associated with both the colorectal cancer characteristics and the prognosis. Methods: The formalin-fixed paraffin-embeddened samples of 529 colorectal cancer tissues were immunostained by antibody for surviving and reviewed by one pathologist. We evaluated correlation between expression and clinicopathologic factors in colorectal cancer, and analyzed variable predicting the risk of death with colorectal cancers. Results: Expression of survivin was detected in 61.8%(327/529) of colorectal cancer tissues, 14.3%(2/14) of adenoma and 0%(0/20) of normal mucosa. There was relationship between the expression of surviving and tumor location(p=0.026), lymph node category(p=0.003) and AJCC stage(p<0.04) on Chi-square test. In survival analysis, Cox proportional model showed that patients age(p<0.001), histologic grade(p<0.001), AJCC stage(p=0.003), and vascular invasion(p=0.007) were the independent determinants of survival time. Conclusions: Survivin expression was correlated with clinicopathologic prognostic parameters and with outcome. Thus it can be both an important source of prognostic information and guide line of neoadjuvant therapy for colorectal cancer. Specially, satge II group with survivin expression showed poorer prognosis than no expression group, therefore should be was treated with neoadjuvant therapy such as stage III.