Correlation between survivin expression and prognosis in non-small cell lung cancer

Aims and Background: Survivin is a recently identified protein as an inhibitor of apoptosis, which supresses programmed cell death and regulates cell division. In this study, we investigated the prognostic significance of both nuclear and cytoplasmic survivin expression in non-small cell lung cancer (NSCLC) and examined the association with clinicopathological parameters. Methods: The study comprised 58 male patients diagnosed NSCLC with a mean age of 57.29±8.82 years; range 40-76 years. Patients underwent lobectomy (64%) or pneumonectomy (36%) with hilar and mediastinal lymph node sampling. Paraffin embedded tumor sections were retrieved for evaluation of nuclear and cytoplasmic staining of survivin. Clinicopathological data, stage and survival of patients were all determined. Results: Cytoplasmic staining was found significantly increased in squamous cell carcinoma (P = 0.003), whereas there was no association between nuclear staining and histopathological type (P = 0.837). Also, both nuclear and cytoplasmic staining did not show any association with tumor stage (P > 0.05). In univariate analysis there was significant correlation between nuclear survivin and short survival (P = 0.0002). In multivariate survival analysis using Cox regression, only nuclear staining of survivin was determined as an independent prognostic factor (P = 0.004). Conclusions: Localization of survivin expression might have an important regulatory mechanism in carcinogenesis and tumor progression. Nuclear survivin expression in tumor tissues might predict the prognosis in NSCLC, whereas cytoplasmic survivin has no prognostic significance.