Prognostic relevance of survivin in pancreatic endocrine tumors.

Abstract:

BACKGROUND:Better prognostic markers are needed for pancreatic endocrine tumors. Survivin is an apoptosis inhibitor that is suggested to have a negative prognostic impact in several tumor types. Contradictory data exist, especially regarding the significance of a nuclear versus cytoplasmic location of survivin. The prognostic relevance of nuclear and cytoplasmic survivin expression in pancreatic endocrine tumors-controlled for the tumor Ki-67 index, World Health Organization classification, and TNM stage-was investigated. METHODS:A total of 111 patients treated at a tertiary referral center were retrospectively evaluated. Clinical data were gathered from medical records. Immunohistochemistry for survivin and Ki-67 was performed on paraffin-embedded tissue. Univariate and multivariate Cox analyses were performed. RESULTS:Patients with tumors that had <5% survivin-positive nuclei had a mean survival of 225 months [95% confidence interval (CI) 168-281]. The corresponding figure for patients with 5 to 50% survivin-positive tumor cell nuclei was 101 months [95% CI 61-140; hazard ratio (HR) 2.4; P < 0.01) and with >50% survivin-positive nuclei 47 months (95% CI 24-71; HR 4.9; P < 0.001). Nuclear survivin expression in >50% of the tumor cells was an independent marker of a poor prognosis (HR 5.7; P < 0.01). Cytoplasmic survivin was not a significant prognostic factor in the multivariate analysis (HR 0.94; P = 0.90). CONCLUSIONS:High expression of nuclear survivin is a significant marker of a poor prognosis in patients with a pancreatic endocrine tumor.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Ekeblad S,Lejonklou MH,Stålberg P,Skogseid B

doi

10.1007/s00268-011-1345-7

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

1411-8

issue

6

eissn

0364-2313

issn

1432-2323

journal_volume

36

pub_type

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