Survivin expression in oesophageal squamous cell carcinoma: its prognostic impact and splice variant expression.

Purpose: The present study examined the clinicopathological impact of survivin expression in oesophageal squamous cell carcinoma (ESCC). In addition, the biological role of anti-apoptosis parameter in ESCC was examined immunohistochemically. Patients and method: Subjects comprised 71 patients followed up for 5 years after surgery for ESCC and analysed immunohistochemically to examine the clinicopathological impact of survivin expression. Separately, 37 fresh frozen samples of ESCC obtained recently were examined concerning splicing variant expression of survivin using reverse-transcription polymerase chain reaction (RT-PCR). Results: Immunohistochemical survivin expression was detected in the nuclei of 10 ESCC specimens (14.1%) and cytoplasm of 22 specimens (31.0%). Nuclear expression displayed no clinicopathological implications, but cytoplasmic expression correlated with histological differentiation (p = 0.002) and tumour invasion (p = 0.073) and showed prognostic impacts in univariate (p = 0.0184) and multivariate (p = 0.0299) analyses. Survivin, survivin-2B and survivin-deltaEx3 mRNA were amplified in 31 (83.8%), 23 (62.2%) and 26 (70.3%) specimens, respectively, by RT-PCR. Survivin-2B level related significantly with histological differentiation (p = 0.038), but no other significant implication was identified between any mRNA and clinicopathological factors. Conclusion: As a molecular biological anti-apoptotic factor, survivin expression was of use in assessing prognosis in ESCC. Inhibition of survivin may be useful as a molecular biological therapy in ESCC. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.