Abstract. Survivin expression in the serum of patients with hepatocellular carcinoma (HCC) and nonmalignant chronic liver diseases remain to be elucidated. The aims of the present study were to evaluate the diagnostic role of survivin in the serum of patients with HCC and identify which ELISA kit performed best in detecting the levels of serum survivin. In total, 80 patients were included in the present study, including 20 patients with HCC, 20 patients with liver cirrhosis, 20 patients with chronic hepatitis B virus infection and 20 healthy volunteers. The levels of survivin protein in the serum were detected using two different ELISA kits (R&D and Abnova). The positive ratios of serum survivin detected by the R&D ELISA kit in all the cases were 8.75% (7/80; median, 0 pg/ml; range, 0-39.8 pg/ml) and in HCC patients were 5% (1/20; median, 0 pg/ml; range, 0-39.8 pg/ml). For the same samples analyzed using the Abnova ELISA kit, the positive ratios of serum survivin in all the cases were 22.5% (18/80; median, 0 pg/ml; range, 0-553.5 pg/ml) and in HCC patients were 25% (5/20; median, 0 pg/ml; range, 0-93.5 pg/ml). The results obtained by the different ELISA kits demonstrated no statistically significant differences in the level of survivin between HCC patients and healthy controls. The correlation coefficient was 0.0064 (P= 0.481) when analyzing the same serum samples with the different ELISA kits. In addition, the highest positive ratio of serum survivin was observed using the Abnova kit. A statistically significant difference in the results was observed between the R&D and Abnova kits. In general, the levels and positive ratios of serum survivin in the patients with HCC were significantly low. Furthermore, no difference was observed between HCC patients and controls in regard to the levels of serum survivin detected by the R&D and Abnova ELISA kits. In conclusion, survivin is unlikely to be a promising serological maker for the diagnosis of HCC.
IntroductionHepatocellular carcinoma (HCC) is the sixth most common malignant neoplasm and the third most common cause of cancer-associated mortalities worldwide (1,2). At present, the combination of α-fetoprotein (AFP) with ultrasonography or computed tomography (CT) is widely used in clinical practice for the early diagnosis of HCC. However, a previous study identified that the sensitivity of AFP was only 25-65%. In addition, a number of patients with chronic hepatitis, liver cirrhosis and other liver diseases or gastrointestinal cancers have been found to exhibit elevated levels of AFP (3). Therefore, identifying novel and promising makers that may improve the diagnostic accuracy of HCC is required. Survivin, also known as baculoviral inhibitor of apoptosis repeat containing 5 (BIRC 5), is an inhibition of apoptosis protein. It was initially separated by researchers from Yale University, and has since been identified to be involved in the inhibition of apoptosis (4) and the regulation of mitosis (5).Previous studies have revealed that survivin is highly expressed in the...