Nuclear Survivin Expression In Nonsmall Cell Lung Carcinoma And Its Clinical Significance

Background: survivin, which is a member of the inhibitorof apoptosis protein family, is over-expressed in manycancers but not in normal differentiated adult tissues.Itregulates both programmed cell death and mitosis. It hasbeen shown that survivin expression and its subcellularlocalization both have prognostic value for patients withmalignant disease. In this study, we investigated whethernuclear staining of survivin was a prognostic marker forpatients with lung carcinoma and demonstrated therelationship between the nuclear survivin and the clinicalcharacteristics in non-small cell lung carcinoma.Patients and methods: Fifty tumor specimens from patientswith non-small-cell lung cancer who underwent operationwere evaluated with immunohistochemistry for survivinexpression and localization. The datum were processed andtested for correlation with major patient characteristics andoverall survival.Results: Survivin was present only in malignant tissues, and43/50 (86%) of the specimens were positive. Three patternsof localization were observed: 40% of cases (20/50) showedreactivity confined to the nucleus, 18% (nine of 50) only inthe cytoplasm and 28% (14/53) in both the nucleus and thecytoplasm. Interestingly, nuclear survivin levels predictedlonger overall survival in univariate analyses. The clinicalcharacteristics except tumor differentiation in non-small celllung carcinoma were not associated with nuclear survivinstaining.Expression of survivin in nucleus did alsosignificantly correlate with the survival rate in NSCLC.Conclusions: Our results indicate that nuclear localizationof survivin may be a prognostic factor for NSCLC. Furtherstudies are warranted.