title: Nuclear survivin is associated with disease recurrence and poor survival in patients with cutaneous malignant melanoma.
abstract: OBJECTIVE
  Survivin is expressed in neoplastic cells and appears to be associated with resistance to therapy and shorter survival in various types of tumours. The aim of the present study was to determine whether nuclear or cytoplasmic expression of survivin is related to disease recurrence and overall survival of patients with Stage I and II melanoma according to the American Joint Committee on Cancer (AJCC) staging system.
  
  
  RESULTS
  Immunohistochemistry was performed on formalin-fixed paraffin-embedded sections of primary cutaneous melanoma from 50 patients. Survival rates were estimated using the Kaplan-Meier method and compared using the log rank test. Association of clinical variables (gender, age, tumour location, thickness, Clark level and AJCC stage) with survivin expression was analysed by Fisher's exact test. Patients with nuclear immunoreactivity for survivin had an increased risk of disease recurrence during the first three postoperative years (P < 0.05) and of death (P < 0.05). Cytoplasmic immunoreactivity was not correlated with either survival or clinical variables.
  
  
  CONCLUSIONS
  Nuclear presence of survivin may be an independent biomarker for disease recurrence and overall survival in patients with Stage I and II melanoma.
authors.affiliation: Department of Cytomorphology, University of Cagliari, Cagliari, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Piras
authors.forename: D
authors.initials: D
authors.lastname: Murtas
authors.forename: L
authors.initials: L
authors.lastname: Minerba
authors.forename: J
authors.initials: J
authors.lastname: Ugalde
authors.forename: C
authors.initials: C
authors.lastname: Floris
authors.forename: C
authors.initials: C
authors.lastname: Maxia
authors.forename: R
authors.initials: R
authors.lastname: Colombari
authors.forename: M T
authors.initials: MT
authors.lastname: Perra
authors.forename: P
authors.initials: P
authors.lastname: Sirigu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D002467:Cell Nucleus / Q000378:metabolism* / Q000473:pathology; D002648:Child; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007124:Immunoenzyme Techniques; D051034:Inhibitor of Apoptosis Proteins; D008297:Male; D008545:Melanoma / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008869:Microtubule-Associated Proteins / Q000378:metabolism*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism*; D009364:Neoplasm Recurrence, Local / Q000378:metabolism*; D009367:Neoplasm Staging; D012878:Skin Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin