Increased survivin mRNA in malignant pleural effusion is significantly correlated with survival.
OBJECTIVE
The sensitivity of cytologic examination of pleural effusions is variable and not predictive of prognosis. Survivin is an inhibitor of apoptosis that may be a novel diagnostic/prognostic marker of cancers. This study aimed to determine the diagnostic and prognostic value of measuring survivin mRNA levels in pleural effusions.


METHODS
Eighty-eight consecutive pleural effusion samples were examined for both cytology and survivin mRNA level. The accuracy of diagnosis and the correlation between survivin mRNA level and survival in malignant pleural effusion (MPE) were determined. Pleural effusions were divided into three groups: Group I, malignancy-associated (n = 44); Group II, inflammatory (n = 27); and Group III, transudative (n = 17).


RESULTS
Survivin mRNA levels in Group I (1.03 +/- 0.61, range 0-2.96) were significantly higher than those in Groups II (0.45 +/- 0.69, range 0-3.30) and III (0.08 +/- 0.22, range 0-0.71) (P < 0.001). Survivin mRNA level was significantly higher in MPE than in non-MPE. The cut-off value for survivin mRNA levels in pleural effusions was 0.074 for the diagnosis of malignancies, with sensitivity, specificity, and positive and negative predictive values of 96%, 45%, 45% and 96%, respectively. Survivin mRNA level in pleural effusions of cancer patients significantly correlated with poor survival.


CONCLUSIONS
Survivin mRNA level is significantly higher in MPEs. Over-expression of survivin mRNA correlates with poor prognosis in cancer patients.
Lan
Chou-Chin
CC
Division of Pulmonary Medicine, Chung Shan Medical University Hospital and School of Medicine, Chung Shan Medical University, Taiwan. tcyt@csmu.edu.tw
Wu
Yao-Kuang
YK
Lee
Chih-Hsin
CH
Huang
Yi-Chih
YC
Huang
Chun-Yao
CY
Tsai
Ying-Huang
YH
Huang
Shiu-Feng
SF
Tsao
Thomas Chang-Yao
TC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics* / Q000378:metabolism; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D008297:Male; D008869:Microtubule-Associated Proteins / Q000235:genetics* / Q000378:metabolism; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000235:genetics* / Q000401:mortality*; D011379:Prognosis; D012333:RNA, Messenger / Q000378:metabolism*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate; D000077022:Survivin; D055815:Young Adult
C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D012333:RNA, Messenger; D000077022:Survivin