Survivin expression as a strong indicator of recurrence in urothelial bladder cancer. Predictive value of nuclear versus cytoplasmic staining.
BACKGROUND
Since its discovery in 1997, survivin has garnered significant interest due to its putative role as an inhibitor of apoptosis. Few studies have investigated the immunohistochemical status of survivin in urothelial bladder carcinoma. The subcellular localization of survivin (nuclear, cytoplasmic) and its differential predictive value is a parameter that previous studies have almost ignored. The aim of this study was to investigate the expression pattern of survivin in order to determine its potential prognostic significance.


METHODS
Archival tumor tissue from 80 patients with urothelial carcinoma were analysed by immunohistochemistry.


RESULTS
Nuclear and cytoplasmic positive scores of 61.25% (49/80) and 22.5% (18/80), respectively were found. Nuclear positive staining correlated strongly with increased grade (p=0.001), stage (p=0.039) and the probability of tumor recurrence (p=0.029). No relationship was found between the cytoplasmic survivin level and the clinicopathological parameters. Nuclear expression was identified as a significant independent predictor of relapse-free survival (p=0.016).


CONCLUSIONS
Nuclear expression of survivin reflects an adverse disease outcome.
Department of Cytopathology, Aretaieion University Hospital, Athens, Greece. skacyt@yahoo.gr
Lazaros
L
Skagias
Ekaterini
E
Politi
Andreas
A
Karameris
Dimitrios
D
Sambaziotis
Athanasios
A
Archondakis
Apostolos
A
Ntinis
Iraklis
I
Moreas
Olympia
O
Vasou
Helen
H
Koutselini
Efstratios
E
Patsouris
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002467:Cell Nucleus / Q000378:metabolism; D003593:Cytoplasm / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins; D008297:Male; D008869:Microtubule-Associated Proteins / Q000096:biosynthesis*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism* / Q000473:pathology; D011237:Predictive Value of Tests; D015996:Survival Rate; D000077022:Survivin; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000473:pathology; D019459:Urothelium / Q000473:pathology
C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D000077022:Survivin