Expression of survivin in renal cell carcinomas: association with pathologic features and clinical outcome.
OBJECTIVE
To investigate the expression of survivin in renal cell carcinoma and try to define its association with certain pathologic features and the clinical outcome.


METHODS
The tissue samples from 85 consecutive renal cell carcinoma specimens were obtained from patients who had undergone radical or partial nephrectomy. The mean follow-up was 45 months (range 3 to 60). Immunohistochemical staining of the paraffin sections of the pathologic sample was performed using monoclonal antibody for survivin with the standard avidin-biotin-peroxidase technique. The mean expression rate of survivin was assessed by inspection of at least five microscopic fields at 400x magnification. Expression of survivin was considered positive when more than 10% of the cancer cells in the microscopic fields demonstrated immunostaining. The degree of expression of survivin was compared with the clinicopathologic features.


RESULTS
Survivin was expressed in 67 (79%) of 85 samples. Immunostaining for survivin was demonstrated in the cytoplasm of tumor cells and in vascular endothelial cells. A significant increase in survivin expression was associated with increased T stage (P = 0.044), increased tumor grade (P = 0.0013), and low recurrence-free survival (P = 0.046). Multivariate Cox regression analysis revealed that survivin expression is an independent prognostic parameter (P = 0.021) in renal cell carcinoma.


CONCLUSIONS
The results of this study suggest that survivin-mediated inhibition of apoptosis is associated with progression and recurrence of renal cell carcinoma. Thus, survivin is a useful independent prognostic marker for this condition.
Byun
Seok-Soo
SS
Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Yeo
Woon Geol
WG
Lee
Sang Eun
SE
Lee
Eunsik
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000737:chemistry / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D007680:Kidney Neoplasms / Q000737:chemistry / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008869:Microtubule-Associated Proteins / Q000032:analysis / Q000096:biosynthesis*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis / Q000096:biosynthesis*; D011379:Prognosis; D012189:Retrospective Studies; D000077022:Survivin
C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin