Significance of survivin expression: Prognostic value and survival in stage III non-small cell lung cancer

Abstract

This study was designed to determine the levels of survivin expression and identify its clinical significance as a prognostic factor for stage III non-small cell lung cancer (NSCLC). A total of 210 cases of stage III NSCLC were collected and the expression levels of survivin and vascular endothelial growth factor A (VEGF-A) in tumor tissues were investigated using immunohistochemistry (IHC). The medical records of the patients were reviewed to determine the association with clinical course. Of the 210 NSCLC tissues, 112 (53.3%) cases demonstrated positive expression of survivin protein. Coexpression of survivin and VEGF-A was identified. The 5-year survival rate of patients with positive survivin expression was significantly lower compared with the survivin-negative cancer patients (P<0.05). The expression of survivin in NSCLC correlated with tumor size. Survivin and VEGF-A were independent prognostic factors of stage III NSCLC. Survivin protein is a valuable marker of prognosis in stage III NSCLC patients.

Figure 1.

Immunohistochemical expression of survivin and VEGF-A protein in NSCLC tissues (SP method; magnification, ×200). (A) Immunoreactivity was observed in the malignant cell cytoplasm. The brown granules in the cytoplasm indicate survivin protein in NSCLC cells. (B) Negative expression of survivin protein in NSCLC tissues. (C) Immunoreactivity was observed in the malignant cell cytoplasm. The brown granules in the cytoplasm indicate VEGF-A expression in NSCLC cells. (D) Negative expression of VEGF-A protein in NSCLC tissues. NSCLC, non-small cell lung cancer; VEGF-A, vascular endothelial growth factor A.

Figure 2.

Overall survival curves for patients with stage III NSCLC according to the expression scores of survivin and VEGF-A. (A) The 5-year survival rates of patients with survivin-positive cancer were significantly lower compared with survivin-negative cancer patients (P<0.05). (B) The 5-year survival rates of patients with VEGF-A positive cancers were significantly lower compared with VEGF-A negative cancer patients (P<0.05). NSCLC, non-small cell lung cancer. VEGF-A, vascular endothelial growth factor A.