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Survivin expression is an independent poor prognostic marker in lung adenocarcinoma but not in squamous cell carcinoma

Virchows Archiv volume 463, pages 427–436 (2013)Cite this article

Abstract

Survivin is a member of the inhibitors of apoptosis and frequently overexpressed in various cancer cells. Overexpression of survivin in lung cancer cells attenuates antitumor effect of tyrosine kinase inhibitors. However, data from the previous studies on the clinicopathologic implication of survivin in non-small-cell lung carcinoma (NSCLC) are inconsistent. We investigated the expression of survivin in 373 cases of surgically resected NSCLC. Correlations between the expression of survivin and clinicopathologic, molecular features and prognostic significance were analyzed. In adenocarcinoma, the increased expression of survivin was associated with the presence of vascular invasion, lymph node metastasis, and tumor recurrences, but we didn’t find any correlation with survivin expression and clinicopathological parameters in squamous cell carcinoma. Patients with high survivin expression had significantly shorter disease-free survival (DFS; 42.2 vs. 58.8 months; p = 0.001) and shorter overall survival (OS; 60.8 vs. 71.5 months; p = 0.009) than those with low survivin expression group in adenocarcinoma. In squamous cell carcinoma, the expression of survivin was not associated with prognosis of the patients (DFS; 48.9 vs. 48.7 months; p = 0.837, OS; 61.0 vs. 62.4 months; p = 0.771). Multivariate analysis confirmed that survivin was an independent poor prognostic factor in adenocarcinoma (DFS: hazard ratio (HR), 1.687; 95 % confidence interval (CI), 1.123–2.532; p = 0.012; OS: HR, 1.965; 95 % CI, 1.108–3.486; p = 0.021). There was no statistically significant difference in the expression of survivin among different molecular subgroups (p > 0.05). Our results suggest that survivin is an independent negative prognostic factor in adenocarcinoma, but not in squamous cell carcinoma. The different prognostic roles played by survivin in adenocarcinoma and squamous cell carcinoma highlights the biological differences between these two histologic types.

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Acknowledgments

This work was supported by grant no. 02-2013-044 from the Seoul National University Bundang Hospital and partly supported by a grant from the Korea Healthcare technology R&D project, Ministry of Health & Welfare, Republic of Korea (A111405).

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The authors declare that they have no conflict of interest.

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Affiliations

  1. Department of Pathology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Republic of Korea

    Ping-Li Sun, Yan Jin, Hyojin Kim, An Na Seo & Jin-Haeng Chung

  2. Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea

    Ping-Li Sun & Sanghoon Jheon

  3. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea

    Choon-Taek Lee

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  1. Ping-Li Sun
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Correspondence to Jin-Haeng Chung.

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Sun, PL., Jin, Y., Kim, H. et al. Survivin expression is an independent poor prognostic marker in lung adenocarcinoma but not in squamous cell carcinoma. Virchows Arch 463, 427–436 (2013). https://doi.org/10.1007/s00428-013-1462-9

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  • DOI: https://doi.org/10.1007/s00428-013-1462-9

Keywords

  • Non-small cell lung cancer
  • Prognosis
  • Apoptosis
  • Survivin