The expression and significance of survivin mRNA in urinary bladder carcinomas

Objective. To investigate the practicability of survivin detection in urine as a novel diagnostic method and prognostic molecular marker of bladder cancer. Methods. Nested RT-PCR was used to detect survivin mRNA expression in urine specimens from 20 healthy persons and patients with bladder carcinomas (n=30), prostate cancer (n=10), and renal cancer (n=6). Results. The result show that survivin was not detected in the urine samples of six of 30 patients with bladder cancer, whereas all the results were negative the other 36 persons. The positive rates of survivin and their expression levels increased with the tumors' histological grade. Six of 21 new-onset bladder tumors did not present survivin mRNA expression; however, none of the nine recurrent bladder tumors were negative, and patients with new-onset bladder tumors (0.5973+/-0.1968) had significantly lower survivin levels than those with recurrent ones (1.1627+/-0.1341)(P=2.10228E-05). We also found that survivin expression was not correlated with gender, age, and clinical stage. Conclusion. The high sensitivity and specificity of urine survivin can indicate the occurrence of bladder carcinomas, and its expression level might be correlated with the malignancy and prognosis of bladder carcinomas. In addition, the fact that survivin was only detected in urine samples of patients with bladder cancer, rather than in normal adult tissue (except thymus gland), suggests that survivin can be used as an ideal target in bladder carcinoma treatment.