title: Expression of survivin in gastric cancer and its relationship with tumor angiogenesis.
abstract: OBJECTIVE
  Survivin, a member of inhibitors of apoptosis, has been found in various human cancers. Its expression is associated with tumor progression and adverse outcome. Angiogenesis is an essential process for the primary tumor to grow and invade the adjacent normal structures. Angiogenic factors such as vascular endothelial growth factor induce survivin expression in endothelial cells. The current study was designed to investigate the possible role of survivin and vascular endothelial growth factor status for angiogenesis in human gastric cancer.
  
  
  METHODS
  In this study, we conducted an immunohistochemical investigation of survivin and vascular endothelial growth factor expression in 106 tissue samples obtained from gastric cancer patients undergoing surgical treatment. To assess tumor angiogenesis, microvessel density was counted by staining endothelial cells immunohistochemically using anti-CD34 monoclonal antibody.
  
  
  RESULTS
  The positive expression of survivin and vascular endothelial growth factor in gastric cancer tissues was demonstrated in 50.0 and 69.8% of cases, respectively. The expression of survivin did not associate with vascular endothelial growth factor expression. Expression of survivin was significantly associated with tumor size, depth of invasion, lymph node metastasis, tumor stage and poor survival (P=0.011, 0.004, 0.020, 0.002, 0.046, respectively). High microvessel density was significantly associated with lymph node metastasis and poor survival (P=0.006 and 0.017, respectively). The mean microvessel density value of survivin positive tumors was 87.4+/-34.4 and significantly higher than that of survivin negative tumors (P=0.016). The mean microvessel density value of vascular endothelial growth factor positive tumors was 98.7+/-37.0 and significantly higher than that of vascular endothelial growth factor negative tumors (P=0.001). A combined analysis of survivin and vascular endothelial growth factor status showed that the mean microvessel density value of both positive tumors was 103.7+/-33.1 and significantly higher than that of both negative tumors (P<0.001).
  
  
  CONCLUSIONS
  These results suggest that survivin may play an important role in carcinogenesis by stimulating tumor angiogenesis in human gastric cancer.
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Gi-Hoon
authors.initials: GH
authors.lastname: Lee
authors.forename: Young-Eun
authors.initials: YE
authors.lastname: Joo
authors.forename: Yang-Seok
authors.initials: YS
authors.lastname: Koh
authors.forename: Ik-Joo
authors.initials: IJ
authors.lastname: Chung
authors.forename: Young-Kyu
authors.initials: YK
authors.lastname: Park
authors.forename: Jae-Hyuk
authors.initials: JH
authors.lastname: Lee
authors.forename: Hyun-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sung-Kyu
authors.initials: SK
authors.lastname: Choi
authors.forename: Jong-Sun
authors.initials: JS
authors.lastname: Rew
authors.forename: Chang-Soo
authors.initials: CS
authors.lastname: Park
authors.forename: Sei-Jong
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D007723:Korea; D008297:Male; D008869:Microtubule-Associated Proteins / Q000378:metabolism*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism*; D009389:Neovascularization, Pathologic / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000098:blood supply* / Q000378:metabolism; D000077022:Survivin; D042442:Vascular Endothelial Growth Factors / Q000378:metabolism*
chemical_list: C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin; D042442:Vascular Endothelial Growth Factors