Expression Of Survivin In Renal Cell Carcinomas: Association With Pathologic Features And Clinical Outcome
The search for molecular markers that are prognostic in renal cell carcinoma (RCC) continues. Survivin is an inhibitor of apoptosis, the over-expression of which has been associated with poor outcomes in many human cancers.
Previous studies have suggested that it may be prognostic in human RCC. Here, Byung and colleagues examine the expression of surviving in human RCC and correlate expression with clinical outcomes.The authors report on 85 patients treated with radical or partial nephrectomy for RCC. Mean follow-up was 45 months (range 3-60). Tumors with more than 10% of tumor cells per high power field that stained positive for surviving were considered positive for expression. Expression was primarily noted in the cytoplasm of tumor cells and in tumor associated endothelial cells. Of the 85 patients, 79% were found to be survivin positive. Elevated expression of survivin was associated with increased T stage (p=0.044), increased tumor grade (p=0.0013), and a shorter recurrence free survival (p=0.046). In multivariate analysis, surviving remained an independent predictor of poor outcome for patients with RCC (p=0.021).Survivin expression is correlated with poor outcomes in RCC. Future research should be directed at comparing the value of this molecular marker in relation to others identified as a prognostic variable. In addition, this molecule could be developed further as an effective therapeutic target.(Source : University of Berkeley at California : April 2007.)