Quantitative analysis of survivin RNA expression in blood as a non-invasive predictor of response to neoadjuvant radiochemotherapy in esophageal cancer.
OBJECTIVE
Analysis of survivin RNA expression in peripheral blood as a non-invasive molecular predictor of response to neoadjuvant radiochemotherapy in patients with locally advanced cancer of the esophagus.


METHODS
Blood samples were drawn from 29 patients with esophageal cancer prior to neoadjuvant radiochemotherapy. After extraction of cellular tumor-RNA from blood samples, quantitative expression analysis of survivin was done by quantitative real-time RT-PCR.


RESULTS
Twenty of 29 (69%) of patients showed a minor histopathological response and 9 of 29 (31%) showed a major-response to neadjuvant radiochemotherapy. RNA expression in blood of patients was detectable for survivin in 27.6%, and in 100% for beta-actin. The mean survivin expression was not significantly different between minor- and major-responders. No significant associations were detected between survivin expression levels and patients clinical variables. A high expression level for survivin was significantly associated with a minor-response to neoadjuvant treatment (P = 0.042). Relative survivin expression levels above 0.15 were not associated with major histopathological response (sensitivity: 35%; specificity: 100%).


CONCLUSIONS
Minor-response to the applied therapy was significantly associated with a high survivin RNA expression level in patient's blood. Survivin appears to be a specific non-invasive predictor of response to neoadjuvant therapy in esophageal cancer.
Grimminger
Peter
P
Department of General-, Visceral-, and Tumor-Surgery, University of Cologne, 50931Cologne, Germany.
Vallböhmer
Daniel
D
Hoffmann
Andreas
A
Schulte
Christian
C
Bollschweiler
Elfriede
E
Schneider
Paul M
PM
Hölscher
Arnulf H
AH
Metzger
Ralf
R
Brabender
Jan
J
D000199:Actins / Q000097:blood; D000230:Adenocarcinoma / Q000097:blood / Q000401:mortality / Q000628:therapy; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000401:mortality / Q000628:therapy; D004938:Esophageal Neoplasms / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D016629:Esophagectomy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D008197:Lymph Node Excision; D008297:Male; D008869:Microtubule-Associated Proteins / Q000097:blood / Q000235:genetics*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012313:RNA / Q000097:blood*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D000077022:Survivin
D000199:Actins; D000964:Antimetabolites, Antineoplastic; C107489:BIRC5 protein, human; D015415:Biomarkers; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D000077022:Survivin; D012313:RNA; D005472:Fluorouracil