title: Prognostic significance of the immunohistochemical index of survivin in glioma: a comparative study with the MIB-1 index.
abstract: OBJECTIVE
  Survivin has been identified as a protein expressed in cancer cells and a member of the inhibitor-of-apoptosis protein family. Recent studies suggest that the expression of survivin increases during the G2/M phase of the cell cycle, and may be used in clinical prognosis. We examined whether survivin expression in human gliomas would be a correlative of prognosis.
  
  
  METHODS
  We prepared polyclonal anti-survivin serum to establish a survivin index for stained sections, using an immunohistochemical procedure, according to the method used for scoring MIB-1 index, and then stained 29 paraffin-embedded sections from surgical specimens of 29 patients who were classified into three grades of World Health Organization with the mean age of low grade astocytoma (grade II) being 34.7; anaplastic astrocytoma (grade III), 48.8; and glioblastoma multiform (grade IV), 58.4.
  
  
  RESULTS
  On staining with the anti-survivin antiserum, all specimens contained positive cells, but the survivin index was heterogeneous among grades. The mean percentage of immunoreactive cells in each specimen was 70.0 (SD 18.2) in grade II, 81.3 (16.5) in grade III, and 85.0 (13.6) in grade IV. Then we compared the survivin index to the MIB-1 index and found that in low-grade gliomas (grade II and III), the difference in survival times between the high and low survivin indexes was significant (P=0.007), whereas that between the high and low MIB-1 indexes was not significant (P=0.092). ONCLUSION: Survivin is more sensitive marker than MIB-1 for the evaluation of low-grade gliomas in that it helps to predict patient survival. Much larger glioma patient series are needed to validate the findings of our limited study.
authors.affiliation: Department of Biochemistry and Cell Biology, Institute of Development and Aging Sciences, Graduate School of Medicine, Nippon Medical School, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Uematsu
authors.forename: Ikuroh
authors.initials: I
authors.lastname: Ohsawa
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Aokage
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Nishimaki
authors.forename: Kouji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Sadamitsu
authors.initials: S
authors.lastname: Asoh
authors.forename: Akira
authors.initials: A
authors.lastname: Teramoto
authors.forename: Shigeo
authors.initials: S
authors.lastname: Ohta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000032:analysis; D014408:Biomarkers, Tumor; D015153:Blotting, Western; D001932:Brain Neoplasms / Q000378:metabolism* / Q000473:pathology; D002648:Child; D018076:DNA, Complementary / Q000235:genetics; D018450:Disease Progression; D005260:Female; D005910:Glioma / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008869:Microtubule-Associated Proteins / Q000032:analysis / Q000378:metabolism*; D008875:Middle Aged; D009363:Neoplasm Proteins; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016019:Survival Analysis; D000077022:Survivin; D016896:Treatment Outcome; D014407:Tumor Cells, Cultured
chemical_list: D000906:Antibodies; C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D018076:DNA, Complementary; D051034:Inhibitor of Apoptosis Proteins; D019394:Ki-67 Antigen; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin