Expression and clinical significance of survivin protein in colorectal carcinoma

OBJECTIVE:To investigate the relationship between the expression of survivin and the clinicopathological parameters in colorectal carcinoma, and evaluate its significance in predicting the prognosis. METHODS: Tissue chip and immunohistochemistry methods by SABC were used to, examine survivin expression in 126 patients with advanced human colorectal cancer, and the relationship between survivin and clinicopathological features and prognosis was retrospectively analysed. RESULTS: The patients were divided into low-and high-survivin groups according to the grade and extent of survivin expression. high-survivin expression was observed in 26(20.6%) cases, low-survivin expression was observed in 100(79.4%) cases. There was no significant correlation between survivin expression and age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis and Dukes classification. However, high survivin expression was strongly correlated with tumor recurrence, especially haematogenous metastasis,P0.05. The survival rate without tumor recurrence for high-and low-survivin groups was assessed by the Kaplan-Meier method and compared by log-rank test. The disease-free survival rate was significantly different between the two groups,P0.05. The multivariate analysis for all patients showed that, among the 8 prognostic factors (age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis and Dukes stage, and survivin expression), Dukes stage and survivin expression was recognized as the independent significant factor related to disease-free survival. CONCLUSIONS: The expression of survivin is strongly correlated with tumor recurrence in colorectal cancer, especially haematogenous metastasis. The recurrence rate is significant higher in the group of high-Survivin expression than in the group of low-survivin erpression. Survivin is the independent dangerous factor related to prognosis. Tissue microarray reveals characteristics of rapid, convenience, economy and accuracy in large-scale application.