The Expression Of Survivin And Its Clinical Significance In Breast Cancer

Objective:To study the expression of inhibitor apoptosis protein of Survivin in breast cancer and its correlation with clinicopathological feature, response to neoadjuvant chemotherapy and prognosis. Mothod:Immunohistochemical staining of Survivin was performed by the standard streptavidin-peroxidase (SP) technique for the paraffin section of 147 breast cancers. TUNEL method was used to get the apoptosis index(AI).The relationship between the Survivin expression and the clinicopathological parameters or the neoadjuvant chemotherapy was analyzed. Kaplan-Meier method was used to investigate the correlation between Survivin expression and survival rate of the patients for whom long term follow up data were available.Result:The expression of Survivin in breast cancerThe positive rate of Survivin in breast cancer was 61.9%(91/147), no expression of Survivin was detected in normal breast tissues.2. Correlation between Survivin expression and linicopathological featureThe positive percent of survivin expression in breast cancer with axillary lymph node metastasis was higher than that without axillary lymph node metastasis(81.7% versus 41.3%; P<0.0001). Statistical analysis revealed that surviving expression was independent of patient's age, tumor size, histological grade, oestrogen receptor status, and stage.Correlation between Survivin expression and apoptotic indexSurvivin expression was strongly associated with the apoptotic index (0.56%±0.48% versus 3.06%±0.21%; P<0.0001).Correlation between Survivin expression and response to neoadjuvant chemotherapySurvivin expression was implicated for the response to the neoadjuvant chemotherapy. The positive percent of survivin expression in complete response groups, part response groups and stable/progress groups was 20.0%, 48.1% and 100.0%. Significant relationship was found between complete response groups and part response/stable/progress groups. Correlation between Survivin expression and patient survival.The 5-year survival rate of patients with Survivin-positive tumors was significantly lower than that of patients with Survivin-negative tumors(79.2% versus 94.0%, P<0.05, log-rank test).Conclusion:A high expression of inhibitor apoptosis protein of Survivin was found in breast cancer. It was not found in normal breast cell. The expression of surviving in breast cnacer was strongly associated with axillary lymph node metastasis, the cell apoptosis index, and response to neoadjuvant chemotherapy. It may be a significant prognostic parameter of worse outcome in breast cancer.