Expression of survivin in astrocytic tumors - Correlation with malignant grade and prognosis

BACKGROUND. Astrocytic tumors are the most common tumors of the central nervous system. The mechanisms of genetic change of astrocytic tumors have not been understood completely. Recently, survivin has been identified as a member of the inhibitor-of-apoptosis family. Survivin expression is considered an important prognostic factor of many tumors. METHODS. The authors investigated 43 astrocytic tumors (8 diffuse astrocytomas; 15 anaplastic astrocytomas; 20 glioblastomas). The authors examined survivin mRNA expression in tumor specimens by reverse transcriptase-polymerase chain reaction amplification. The authors analyzed the relationship between survivin expression and other molecular changes commonly found in astrocytic tumors [p53 alteration, overexpression of epidermal growth factor receptor (EGFR), and bcl-2 expression]. RESULTS. Thirty-four of 43 (79.1%) astrocytic tumors expressed survivin. The distributions included 3 of 8 (37.5%) diffuse astrocytomas, 13 of 15 (86.7%) anaplastic astrocytomas, and 18 of 20 (90.0%) glioblastomas. Expression of survivin (P = 0.0057) and EGFR (P = 0.0112) was significantly associated with malignant grade of astrocytic tumors, but expression of p53 (P = 0.1893) and bcl-2 (P = 0.2552) was not. Furthermore, patients with survivin-positive astrocytic tumors had significantly shorter overall survival times compared with patients who had survivin-negative tumors (P = 0.0271). CONCLUSIONS. Survivin expression in astrocytic tumors varies with histologic malignancy and may play an important role in the oncogenesis and progression of astrocytic tumors. These data suggest that survivin has great potential as a therapeutic target in astrocytic tumors.