Survivin and laryngeal carcinoma prognosis: Nuclear localization and expression of splice variants

Aims: Aberrant survivin expression in cancer cells has been associated with tumour progression, radiation/drug resistance and shorter patient survival. The aim of the present study was to investigate survivin expression in laryngeal carcinoma (LSCC) tissue and-for the first time at this site-the expression of survivin splice variants. P53 was also studied. Methods and results: Survivin and p53 expression was determined immunohistochemically in 86 consecutive patients operated for LSCC. Survivin mRNA expression was assessed by quantitative real-time polymerase chain reaction (PCR). Hot-spot mutations in exons 5, 6, 7 and 8 of the TP53 gene were studied by sequencing analysis. A nuclear localization for survivin predominated. There was a significant association between a higher nuclear survivin expression and LSCC recurrence (P=0.046). Disease-free survival (DFS) for LSCC patients with a nuclear survivin expression >7.0% was shorter than in cases whose expression was ≤7.0% (P=0.05). Wild-type survivin correlated significantly with nuclear survivin expression (P=0.02). p53 expression was associated with the co-expression of wild-type survivin and survivin-2B (P=0.01). Conclusions: Nuclear expression of survivin appears to influence LSCC aggressiveness, a higher nuclear survivin expression correlating with a higher recurrence rate and a shorter DFS. Wild-type survivin was the most frequently detected splice variant in LSCC tissues.