Long-term maintenance of prognostic value of survivin and its relationship with p53 in T4 breast cancer patients

Abstract

a large proportion of human tumors show deregulated expression of a variety of proteins that play a crucial role in the execution of the apoptotic program. Survivin belongs to the family of inhibitor of apoptosis proteins which were originally identified in baculoviruses. ectopic expression of survivin conveys resistance to apoptosis to a variety of stimuli, and survivin is one of the most abundantly overexpressed genes in human tumors such as breast cancer. in this study we examined the expression of survivin protein in a series of t4 breast cancers to identify any correlation with long-term patient outcomes. moreover, we investigated the hypothesis of a possible association between p53 and survivin as a factor further complicating the outcome. archival specimens from 53 t4 breast cancer patients were included in the study and treated for the immunohistochemical localization of survivin and p53 using the streptavidin-biotin alkaline phosphatase method. the immunoreactivity was evaluated semiquantitatively according to the percentage of cells stained. Forty percent of tumors were positive for survivin. Statistical analysis revealed that survivin expression negatively influenced the 5-and 10-year disease-free and overall patient survival. in multivariate analysis, survivin expression was a significant independent prognostic indicator of worse outcome in overall survival [hazard ratio (hr)=2.61]. Our results showed that survivin is associated with a worse prognosis in patients with t4 breast cancer, and remarkably its prognostic relevance is maintained even long-term. notably, p53 (hr=3.2) seems to negatively enhance the effect of survivin on survival. departments of 1 medical Oncology, 2 cytomorphology, and 3 public health, university of cagliari, i-09042 monserrato (ca), italy

Nestin expression associates with poor prognosis and triple negative phenotype in locally advanced (T4) breast cancer

“…A distinct gene-expression profile has been described for T3/T4 tumours in comparison to the gene-expression pattern of T1/T2 tumours, 19 suggesting that a distinct biological behaviour may characterize initial vs. locally advanced breast carcinomas. 20 , 21 …”

Prognostic significance of survivin in rectal cancer patients treated with surgery and postoperative concurrent chemo-radiation therapy

“…It inhibits apoptosis or programmed cell death-related proteins such as caspase-3 and caspase-7, and also regulates cell division by localizing in the mitotic spindle and interacting with tubulin. There are many reports showing a clear relationship between the expression of survivin and dismal clinical outcomes in several sites of cancer [ 15 – 17 , 23 , 24 ].…”

“…There are many apoptotic regulators that have been identified as prognostic factors. Among these molecular markers, survivin and p53 have been actively investigated in many cancer types, including breast cancer, non-small cell lung cancer, and colorectal cancer [ 15 – 17 ]. They are also known to play a critical role in apoptotic pathways and cell cycle control in mammalian cells [ 18 ].…”