Preoperative survivin mRNA detection in peripheral blood is an independent predictor of outcome in esophageal carcinoma.
OBJECTIVE
Survivin (SVV) mRNA expression levels in peripheral blood of patients with gastrointestinal malignancies change significantly during the course of treatment. We wanted to scrutinize these findings in patients with esophageal carcinoma and furthermore evaluate whether the detection of mRNA and the change in detecting ability have an association with overall survival.


METHODS
Whole blood was drawn 1 day pre- and 10 days post-operatively from 62 patients with esophageal carcinoma. Tumor cells were enriched from whole blood by density-gradient centrifugation prior to extraction of total cellular RNA and subsequent direct quantitative reverse transcriptase-PCR assays.


RESULTS
SVV was detectable in 48 out of 62 patients (77%). Stepwise multivariate Cox linear regression models demonstrated a significant and independent association of measured SVV with overall survival (6.6 exp[b]; 95% CI: 1.97-22.12; p = 0.002). Increased SVV levels after the operation were linked to shorter overall survival (p = 0.04).


CONCLUSIONS
Preoperative SVV expression levels appear to be associated with overall survival in patients with esophageal cancers. Increasing levels could potentially indicate a higher risk for shorter overall survival and therefore demand adapted treatment modalities.
Department of Medicine (Cancer Research), Molecular Oncology Risk-Profile Evaluation, West German Cancer Center, University Hospital Essen, Hufelandstrasse 55, Essen, 45147, Germany. hoffmann@more-oncology.com
Andreas-Claudius
AC
Hoffmann
Daniel
D
Vallböhmer
Peter
P
Grimminger
Ralf
R
Metzger
Klaus L
KL
Prenzel
Arnulf H
AH
Hoelscher
Jan
J
Brabender
D000230:Adenocarcinoma / Q000097:blood / Q000235:genetics / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000235:genetics / Q000601:surgery; D004938:Esophageal Neoplasms / Q000097:blood* / Q000235:genetics* / Q000601:surgery; D005260:Female; D015870:Gene Expression; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D053208:Kaplan-Meier Estimate; D008297:Male; D008869:Microtubule-Associated Proteins / Q000235:genetics*; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D010597:Pharmacogenetics; D057234:Preoperative Period; D011379:Prognosis; D012333:RNA, Messenger / Q000097:blood* / Q000235:genetics*; D000077022:Survivin
C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D012333:RNA, Messenger; D000077022:Survivin