Survivin expression in intracranial ependymomas and its correlation with tumor cell proliferation and patient outcome.
Survivin expression has been described as prognostic factor in various tumor types and has been shown to correlate with cytologic anaplasia in ependymoma. We immunohistochemically studied survivin expression and its association with Ki-67 and topoisomerase IIalpha (TIIalpha) expression and outcome in 63 patients with intracranial ependymoma. Survivin is expressed in a fraction of nuclei of tumor and endothelial cells including mitotic figures. Survivin indices range from 0.6% to 43.2% and correlate with Ki-67 and TIIalpha indices. On average, 62.86% of Ki-67-expressing tumor cell nuclei coexpress survivin, whereas 92.2% of survivin-expressing nuclei coexpress Ki-67. High survivin, Ki-67, and TIIalpha indices univariately correlated with an unfavorable outcome. In multivariate analysis, only the Ki-67 index remained an independent prognostic factor. In ependymoma, survivin is expressed in a subset of proliferating cells. High survivin expression is associated with poor patient outcome. However, the Ki-67 index is a more accurate prognostic marker than the survivin or TIIalpha index.
Preusser
Matthias
M
Institute of Neurology, Medical University of Vienna, Vienna, Austria.
Wolfsberger
Stefan
S
Czech
Thomas
T
Slavc
Irene
I
Budka
Herbert
H
Hainfellner
Johannes A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000378:metabolism; D001317:Austria / Q000453:epidemiology; D014408:Biomarkers, Tumor; D001932:Brain Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002467:Cell Nucleus / Q000378:metabolism / Q000473:pathology; D049109:Cell Proliferation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015853:Cysteine Proteinase Inhibitors / Q000378:metabolism*; D004250:DNA Topoisomerases, Type II / Q000378:metabolism; D004268:DNA-Binding Proteins / Q000378:metabolism; D004806:Ependymoma / Q000378:metabolism* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D006801:Humans; D007223:Infant; D051034:Inhibitor of Apoptosis Proteins; D019394:Ki-67 Antigen / Q000378:metabolism; D008869:Microtubule-Associated Proteins / Q000378:metabolism*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism*; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D000077022:Survivin
D000951:Antigens, Neoplasm; C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D015853:Cysteine Proteinase Inhibitors; D004268:DNA-Binding Proteins; D051034:Inhibitor of Apoptosis Proteins; D019394:Ki-67 Antigen; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin; D004250:DNA Topoisomerases, Type II