Expression of survivin in squamous cell carcinoma and transitional cell carcinoma of the urinary bladder: A comparative immunohistochemical study
Makboul Rania, Refaiy Abeer EL-Refaiy M., Badary Fatma Ahmed Mahmoud, Abdelkawi Islam F., Merseburger Axel S., Mohammed Rabab Ahmed Ahmed,
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( Makboul Rania )
Assiut University Faculty of Medicine Department of Pathology
( Refaiy Abeer EL-Refaiy M. )
Assiut University Faculty of Medicine Department of Pathology
( Badary Fatma Ahmed Mahmoud )
Assiut University Faculty of Medicine Department of Pathology
( Abdelkawi Islam F. )
Egypt Assiut University Faculty of Medicine Department of Urology
( Merseburger Axel S. )
Egypt Assiut University Faculty of Medicine Department of Urology
( Mohammed Rabab Ahmed Ahmed )
Assiut University Faculty of Medicine Department of Pathology
KMID : 0358320150560010031
Abstract
Purpose: To compare the expression of survivin and its association with clinicopathological criteria in major types of urinary bladder carcinoma, specifically, transitional cell carcinoma with and without squamous differentiation and squamous cell carcinoma.
Materials and Methods: Immunohistochemical staining for survivin and Ki67 was performed on paraffin-embedded sections of 104 carcinomas: 52 transitional cell carcinoma, 20 transitional cell carcinoma with squamous differentiation, and 32 squamous cell carcinoma. Expression of survivin in >10% of tumor cells was described as altered survivin status. Ki67 staining in >20% of tumor cells was described as a high proliferation index.
Results: Altered survivin expression was detected in 60/104 specimens (58%) and was significantly more frequent in transitional cell carcinoma (78%) than in squamous cell carcinoma (38%) or transitional cell carcinoma with squamous differentiation (40%) (p<0.0001). In transitional cell carcinoma but not in squamous cell carcinoma, altered survivin status was associated with higher tumor grade, higher proliferation index, and recurrence. In the whole specimens, altered survivin expression was significantly associated with advanced stage (p<0.001), recurrence (p=0.005), distant metastasis (p<0.001), and death (p=0.001). In the multivariate analysis, altered survivin was an independent poor prognostic factor for recurrence.
Conclusions: Unlike in transitional cell carcinoma, alteration of survivin expression in squamous cell carcinoma occurs less frequently and is not associated with features of tumor aggression or patient outcome. These findings raise a question: are urinary bladder carcinoma patients with squamous cell carcinoma type suitable candidates for survivin vaccine? This is an important question to be answered before approving the vaccine in management.
키워드
Squamous cell carcinoma; Transitional cell carcinoma; Urinary bladder; Vaccines
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