Correlation between survivin expression and locoregional control in cervical squamous cell carcinomas treated with radiation therapy.
OBJECTIVE
Survivin is a member of the inhibitors of apoptosis and has been implicated in both the regulation of cell division and the suppression of apoptosis. Over-expression of cytoplasmic survivin correlates with an unfavorable prognosis in many malignant tumors. However, the prognostic value of nuclear survivin expression is still equivocal. Here, we investigated the prognostic value of survivin expression in cervical cancer treated with radiation therapy.


METHODS
Tissue sections were obtained from 72 patients with cervical squamous cell carcinoma treated with radiation therapy alone. Survivin expression levels were determined by immunohistochemical staining and evaluated for cell positivity. The correlation between survivin expression and clinical outcome endpoints including cause-specific survival and local control were evaluated.


RESULTS
A total of 14% (10/72) of tissue specimens had greater than 5% nucleus positivity, while 47% (34/72) had greater than 50% cytoplasmic positivity. Local control rate of the cytoplasmic survivin-negative tumors was 94%, significantly higher than the 76% of the positive tumors (p=0.046). Local control rate of the nuclear survivin-positive and cytoplasmic survivin-negative patients was 95%, significantly higher than the 74% of the other patients (p=0.02). In contrast, no significant correlation was noted between survivin expression and disease-free survival.


CONCLUSIONS
The cytoplasmic survivin expression alone and the combination of nuclear and cytoplasmic expression were suggested to be predictors for local control in patients with cervical squamous cell carcinoma treated with radiation therapy alone.
Suzuki
Yoshiyuki
Y
Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. syoshi@med.gunma-u.ac.jp
Oka
Kuniyuki
K
Yoshida
Daisaku
D
Shirai
Katsuyuki
K
Ohno
Tatsuya
T
Kato
Shingo
S
Tsujii
Hirohiko
H
Nakano
Takashi
T
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000532:radiotherapy*; D002467:Cell Nucleus / Q000378:metabolism; D003593:Cytoplasm / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins / Q000096:biosynthesis*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000096:biosynthesis*; D000077022:Survivin; D002583:Uterine Cervical Neoplasms / Q000378:metabolism* / Q000532:radiotherapy*
C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin