The Influence Of Survivin On Chemotherapy And Prognosis In NSCLC

Backgroud Lung cancer is still the most common cause of cancer death. As a new member of IAP (inhibitors of apoptosis protein) family, Survivin has potent anti-apoptotic activities, and involves in the mitosis and angiogenesis. Researches have demonstrated that Survivin is a tumor-specific anti-apoptotic factor, expressed in fetal tissues, and common human cancers, while not in normal, terminally differentiated adult tissues. Several in vitro and in vivo studies have proven that the overexpression of Survivin in tumor tissues is correlated with poor prognosis of the patients.Objectives By investigating the expression of Survivin in non-small cell lung cancer (NSCLC) and exploring the influence of Survivin on chemical therapy and prognosis in NSCLC, we expect to provide the theoretical basis for clinical diagnosis and therapy.Methods From March 2004 to March 2005, 123 cases of NSCLC obtained follow-up. Immunohistochemical ENVISION method was used to detect the expression of Survivin in 86 patients with NSCLC and 10 normal tissues of the lung. The relationships between expression of Survivin and clinic pathological parameters, expression of Survivin and 1-year survival rates were analyzed. Then we used the same method to detect the expression of Survivin in 37 patients with advanced NSCLC, observing their responses to cisplatin based chemotherapy. Results (1) The positive rate of Survivin in NSCLC was 86.05% (74/86 ). While there was no Survivin expressing in normal lung tissues;(2) The expression of Survivin in NSCLC could be detected in cytoplasm and/or in nucleus. Cytoplasmic, nuclear and both immunoreactivities were present in 31.40% (27/86 ) , 12.79% (11/86) and 41.86% (36/86 ) respectively;(3) The positive expression rates of Survivin did not correlate with the patients' gender, age,histological subtype and differentiation (P>0.05) , but correlated with TNM stages and lymph node matastasis(P<0.05 );(4) The higher Survivin cytoplasmic and nuclear immuoreactivities in NSCLC were detected, the lower 1-year survival rates the NSCLC patients had. And there was significant difference (P< 0.05 );(5) The expression levels of Survivin in NSCLC patients were linearly related with their TNM stages (P<0.01) and the Spearman rank order correlation coefficient is 0.4760;(6) The positive rate of Survivin was extremely high in advanced NSCLC (97.30%, 36/37) . Tumor response rate to chemotherapy was 29.73%;(7) The response to chemotherapy did not correlate with the patients' gender, age, histological subtype, differentiation, TNM stages and chemotherapy schemes (P> 0.05);(8) The expression levels of Survivin in advanced NSCLC patients were linearly related with their responses to chemotherapy (P<0.01) and the Spearman rank order correlation coefficient is 0.4584.Conclusion Survivin was specific highly expressed in NSCLC, especially in advanced NSCLC. The expression levels of Survivin in NSCLC patients were linearly related with their TNM stages and responses to chemotherapy. It can be used as a prognostic factor and a new target in NSCLC targeting therapy.