Background & objective: Survivin, an inhibitor of apoptosis protein, is correlated to aggressive behavior, resistance to chemotherapy and radiotherapy, and prognosis of human cancers. It is expressed in both nuclei and cytoplasm. Recent research revealed that the nuclear expression of survivin is an important prognostic factor of human cancers. This study was to investigate the nuclear expression of Survivin in human glioma, and its correlations to clinicopathologic characteristics and prognosis.
Methods: The nuclear expression of Survivin in 88 specimens of glioma (33 at grade I-II, and 55 at grade III-IV) was detected by tissue microarray and immunohistochemistry. Its correlations to clinicopathologic characteristics and prognosis were analyzed.
Results: The positive rate of nuclear Survivin was 27.3% in the whole group. It was significantly lower in grade I-II gliomas than in grade III-IV gliomas (12.1% vs. 36.4%, P=0.013). Nuclear expression of Survivin had no correlation to patient's age (P=0.053), sex (P=0.376), Karnofsky performance status (P=0.486), and clinical stage (P=0.359). The 5-year overall survival rate and 3-year disease-freely survival rate were significantly lower in nuclear Survivin-positive group than in nuclear Survivin-negative group (22.7% vs. 47.7%, P=0.005; 13.7% vs. 39.5%, P=0.015). The median survival was slightly lower in high nuclear Survivin expression group than in low nuclear Survivin expression group (14.9 months vs. 20.2 months, P=0.089).
Conclusions: The nuclear expression of Survivin is related to the pathologic grade of glioma, and might be a negative prognostic factor of glioma.