Effect of apoptotic and proliferative indices, P-glycoprotein and survivin expression on prognosis in laryngeal squamous cell carcinoma

This study was to explore the relationship between P-glycoprotein and survivin expression with apoptotic index, proliferative index, clinicopathologic characteristics, and their prognostic value in laryngeal squamous cell carcinoma (LSCC). Samples from 86 patients with LSCC were analyzed for P-glycoprotein, survivin, and Ki-67 expression by immunohistochemistry and apoptotic index by the TUNEL method. The association of P-glycoprotein and survivin expression with clinicopathologic parameters, apoptotic and proliferative activities, and patients' overall survival was subsequently analyzed. We found that up-regulation of P-glycoprotein expression was associated with decreased apoptosis but not with changes in proliferation, whereas increased survivin expression was correlated with decreased apoptosis and increased proliferation. There was a positive correlation between P-glycoprotein and survivin expression. Expression of these two proteins was significantly related to the clinical stage, histological grade, lymph node metastasis, and overall survival in LSCC. These results reveal that survivin and P-glycoprotein may have an effect on chemotherapy resistance and progression of LSCC through promoting proliferation and/or suppressing apoptosis. Furthermore, our results demonstrate that P-glycoprotein and survivin proteins are both predictive of malignant progression and prognosis of LSCC.