Clinical significance of high levels of survivin and transforming growth factor beta-1 proteins in aqueous humor and serum of retinoblastoma patients.
To evaluate the diagnostic and prognostic values of survivin and transforming growth factor beta-1 (TGF-B1) expression in aqueous humor and serum of retinoblastoma (RB) in comparison to the conventional RB marker lactate dehydrogenase (LDH) and to elucidate a possible correlation between them and the clinicopathological features of the disease.



This prospective, comparative study included 88 newly diagnosed children with RB and 80 age-matched controls with ophthalmic conditions other than tumors prepared for intraocular surgeries. Concentrations of survivin, TGF-B1, and LDH were measured in serum and aqueous humor before and 6 months after completion of therapy.



High serum and aqueous humor concentrations of the three proteins were detected in RB patients before treatment compared to the control group (P < 0.01), with a significant reduction of serum concentrations after treatment (P < 0.01). For the highest sensitivity and specificity, the optimal cutoff values of serum and aqueous survivin were 12.9 pg/ml and 25.2 pg/mg, with a significant positive correlation between aqueous survivin and RB staging and presence of optic nerve infiltration (r = 0.43, P = 0.04); the best cutoff values of serum and aqueous TGF-B1, 370.7 pg/ml and 39.8 pg/mg, with a significant positive correlation between aqueous TGF-B1 and poor differentiation of the tumor (r = 0.69, P = 0.001).



The high sensitivity, specificity, and accuracy of serum and aqueous humor survivin and TGF-B1 proteins make them promising markers for early detection and follow-up of RB patients.
Medical Biochemistry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Hanan Hussein
HH
Shehata
Medical Biochemistry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Azza Hassan
AH
Abou Ghalia
Medical Biochemistry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Eman Khairy
EK
Elsayed
Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: dr_azza_22@hotmail.com.
Azza Mohamed
AM
Ahmed Said
Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Safaa Saleh
SS
Mahmoud
D001082:Aqueous Humor / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D015353:Eye Enucleation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D051034:Inhibitor of Apoptosis Proteins / Q000097:blood*; D008297:Male; D009363:Neoplasm Proteins / Q000097:blood*; D011446:Prospective Studies; D015203:Reproducibility of Results; D019572:Retinal Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D012175:Retinoblastoma / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D012680:Sensitivity and Specificity; D000077022:Survivin; D053773:Transforming Growth Factor beta1 / Q000097:blood*
C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D009363:Neoplasm Proteins; D000077022:Survivin; D053773:Transforming Growth Factor beta1