title: Prognostic significance of survivin in resected gallbladder cancer.
abstract: BACKGROUND
  Survivin, a novel inhibitor of apoptosis, plays a role in oncogenesis and has been correlated with poor prognosis. We investigated its expression in gallbladder tissues of control, cholelithiasis, and gallbladder cancer (GBC). Survivin expression was correlated with different clinicopathologic parameters including prognosis in patients with GBC.
  
  
  METHODS
  Gallbladder tissue samples were collected from GBC (n = 39), cholelithiasis (n = 30), and control (n = 25). Expression of survivin messenger RNA (mRNA) was evaluated by real time polymerase chain reaction. Protein quantification was done by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Significantly higher expression of survivin mRNA was observed in GBC (2.9-fold) and cholelithiasis (1.85-fold) as compared with control (P < 0.0001). In GBC, increased survivin expression (mRNA and protein) was significantly associated with higher tumor stage (stage III versus stage II) (P < 0.0001) and poor tumor differentiation (poor and moderate versus well) (P < 0.0001). No significant correlation was observed with any of the other clinicopathologic factors studied. Increased expression of survivin was associated with shorter survival (median survival 11.5 mo versus 18 mo).
  
  
  CONCLUSIONS
  Differential expression of survivin in GBC suggests its possible role in gallbladder carcinogenesis. Its overexpression is associated with poor prognosis. Assessment of survivin might be used to stratify GBC patients for optimal treatment modalities, including targeted therapy.
authors.affiliation: Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Jaya
authors.initials: J
authors.lastname: Nigam
authors.affiliation: Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, India. Electronic address: abhijitchandra@hotmail.com.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Chandra
authors.affiliation: Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Hasan Raza
authors.initials: HR
authors.lastname: Kazmi
authors.affiliation: Developmental Toxicology Division, Indian Institute of Toxicology Research (IITR), Lucknow, Uttar Pradesh, India.
authors.forename: Devendra
authors.initials: D
authors.lastname: Parmar
authors.affiliation: Department of Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Devendra
authors.initials: D
authors.lastname: Singh
authors.affiliation: Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Vishal
authors.initials: V
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000032:analysis / Q000235:genetics / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012333:RNA, Messenger / Q000032:analysis; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D012333:RNA, Messenger; D000077022:Survivin
keywords: Cholelithiasis; ELISA; Gallbladder cancer; Prognosis; Real time PCR; Survivin