title: Clinical significance of survivin expression in patients with urothelial carcinoma.
abstract: BACKGROUND
  Survivin is a member of the inhibitors of apoptosis protein family that plays an important role in carcinogenesis. Here, we examined the association between survivin expression and clinical outcome in urothelial carcinoma of the bladder (UCB).
  
  
  METHODS
  A total of 56 histopathologically confirmed UCB patients were recruited from the Department of Urology of Chiayi Christian Hospital from August 2007 to May 2009. Immunohistochemistry (IHC) was used to detect the survivin expression in tumor tissues. The -31 C/G polymorphism in survivin promoter region was determined by polymerase chain reaction-restricted fragment length polymorphism.
  
  
  RESULTS
  The frequency of high survivin expression was significantly higher in muscle-invasive tumors (66.6%) than in non-muscle-invasive tumors (34.2%) (P = 0.042) and in poorly differentiated (85.7%) tumors than in moderately differentiated tumors (30.8%) (P = 0.0014). The higher frequency of risk genotypes (C/C and C/G) was found in the median (72.7%) and high (68.0%) survivin expression groups. The multivariate analysis showed that a high survivin expression level was a potential predictive biomarker of poor overall survival (P = 0.02).
  
  
  CONCLUSIONS
  Our results suggest that the high survivin expression was associated with tumor stage and grade and may present a predictive marker of overall survival in UCB.
authors.affiliation: Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan ; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.
authors.forename: Hsin-An
authors.initials: HA
authors.lastname: Chen
authors.affiliation: Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan ; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.
authors.forename: Chih-Ming
authors.identifier: 0000-0002-1035-4238
authors.initials: CM
authors.lastname: Su
authors.affiliation: Department of Biomedical Research, Chiayi Christian Hospital, Chiayi 600, Taiwan.
authors.forename: Hsiao-Yen
authors.initials: HY
authors.lastname: Hsieh
authors.affiliation: Department of Pathology, Chiayi Christian Hospital, Chiayi 600, Taiwan.
authors.forename: Chun-Liang
authors.initials: CL
authors.lastname: Tung
authors.affiliation: Department of Biomedical Research, Chiayi Christian Hospital, Chiayi 600, Taiwan.
authors.forename: Cheng-Da
authors.initials: CD
authors.lastname: Hsu
authors.affiliation: Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan ; Division of General Surgery, Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
authors.forename: Yuan-Hung
authors.initials: YH
authors.lastname: Wang
authors.affiliation: Department of Urology, Chiayi Christian Hospital, 539 Chung Hsiao Road, Chiayi 600, Taiwan ; Tainan University of Technology, Tainan City 71002, Taiwan.
authors.forename: Cheng-Huang
authors.initials: CH
authors.lastname: Shen
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002295:Carcinoma, Transitional Cell / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D004848:Epithelium / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D000077022:Survivin; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin