Expression of survivin, a novel inhibitor of apoptosis, in superficial transitional cell carcinoma of the bladder.
OBJECTIVE
We investigated whether the over expression of survivin, a new antiapoptotic protein, might provide prognostic information in patients with superficial bladder cancer.


METHODS
Immunohistochemical staining of paraffin sections using a monoclonal antibody for survivin was performed in 88 cases of superficial bladder cancer using the standard avidin-biotin-peroxidase technique. The relationships between the expression of survivin, clinicopathological characteristics and clinical outcome were analyzed.


RESULTS
Survivin expression was found in tumor cells but not in nonneoplastic bladder tissues. High expressions (greater than 20%) of survivin were observed in 51 cases (58.0%) and low expression in 37 cases. No statistically significant association was observed between survivin expression and tumor grade (p = 0.052) or pathological stage (p = 0.131). When clinical data such as sex, age, tumor number, size or shape were examined in conjunction with survivin status no statistically significant relationship was noted. Patients with a high expression of survivin had worse disease-free survival rates than those with low survivin expression (log rank test p = 0.0004). Multivariate Cox proportional hazards model analysis identified survivin expression as an independent prognostic factor of disease-free survival (p = 0.009, relative risk = 3.17).


CONCLUSIONS
Our findings suggest that high survivin expression may be considered a new unfavorable prognostic factor in superficial bladder cancer.
Ku
Ja Hyeon
JH
Department of Urology, Military Manpower Administration, Seoul, Korea.
Kwak
Cheol
C
Lee
Hye Sun
HS
Park
Hyound Keun
HK
Lee
Eunsik
E
Lee
Sang Eun
SE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000032:analysis / Q000096:biosynthesis* / Q000502:physiology; D017209:Apoptosis; D002295:Carcinoma, Transitional Cell / Q000737:chemistry / Q000378:metabolism*; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D008297:Male; D008869:Microtubule-Associated Proteins / Q000032:analysis / Q000096:biosynthesis* / Q000502:physiology; D008875:Middle Aged; D009363:Neoplasm Proteins; D011379:Prognosis; D000077022:Survivin; D001749:Urinary Bladder Neoplasms / Q000737:chemistry / Q000378:metabolism*
D000951:Antigens, Neoplasm; C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin