title: The prognostic significance of survivin expression in gallbladder carcinoma.
abstract: Gallbladder cancers (GBC) are characterized by rapid progression, early metastasis, and poor prognosis; the molecular mechanisms of the various signaling pathways involved should be elucidated to develop effective therapies. Survivin, an apoptosis inhibitor protein expressed in the G2/M phase of the cell cycle, plays a role in cell division and affects both cell survival and proliferation. Survivin has been investigated in many types of cancer, and this study aims to examine the relationship of survivin expression in gallbladder cancer patients with clinicopathological features and prognosis. We evaluated demographic characteristics (age, gender), tumor characteristics (histopathological type, differentiation, perineural, and lymphovascular invasion; serosal invasion, surgical margin positivity and lymphocytic response), and Survivin expression immunohistochemically, and we analysed the relationship between these characteristics and prognosis in 47 gallbladder carcinoma cases from 2000 to 2011. Immunohistochemically, while survivin expression was observed in 36 cases, it was absent in 11 cases. Follow-up data were obtained from 32 patients. Two (8.7%) of 23 cases with a Survivin-positive tumor were alive at 74th and 35th months, whereas 5 (%55.6) of nine cases with Survivin-negative tumor were alive at 50th, 89th, 124th, 126th, 131th months. Survivin expression was correlated with short survival (p = 0.043), and the univariate analysis showed that reduced overall survival was associated with age (p = 0.043), male gender (p = 0.038), infiltrative pattern (p = 0.019), lymphovascular invasion (p = 0.004), perineural invasion (p = 0.009), serosal invasion (p = 0.027), ulcer (p = 0.033), and surgical margin positivity (p = 0.022). Despite the low number of patients in our study, the analysis results suggest that survivin positivity might actually be a significant prognostic factor. This finding could be a reference point for targeted treatment studies. However, further studies involving broader series and longer follow-up are still required for highly lethal gallbladder cancers.
authors.affiliation: Department of Medical Oncology, Izmir Katip Celebi University, Atatürk Training and Research Hospital, Izmir, Turkey.
authors.forename: Tarik
authors.initials: T
authors.lastname: Salman
authors.affiliation: Department of Pathology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
authors.forename: Asuman
authors.initials: A
authors.lastname: Argon
authors.affiliation: Department of Pathology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
authors.forename: Tulu
authors.initials: T
authors.lastname: Kebat
authors.affiliation: Department of Pathology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
authors.forename: Enver
authors.initials: E
authors.lastname: Vardar
authors.affiliation: Department of General Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
authors.forename: Nazif
authors.initials: N
authors.lastname: Erkan
authors.affiliation: Department of Medical Oncology, Izmir Katip Celebi University, Atatürk Training and Research Hospital, Izmir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Alacacıoğlu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012737:Sex Factors; D016019:Survival Analysis; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin
keywords: Survivin; apoptosis inhibitor protein; gallbladder cancer; prognosis