Expression of survivin in squamous cell carcinoma and transitional cell carcinoma of the urinary bladder: A comparative immunohistochemical study

다국어 초록 (Multilingual Abstract)

Purpose: To compare the expression of survivin and its association with clinicopathological criteria in major types of urinary bladdercarcinoma, 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 of104 carcinomas: 52 transitional cell carcinoma, 20 transitional cell carcinoma with squamous differentiation, and 32 squamous cellcarcinoma. Expression of survivin in >10% of tumor cells was described as altered survivin status. Ki67 staining in >20% of tumorcells was described as a high proliferation index.
Results: Altered survivin expression was detected in 60/104 specimens (58%) and was significantly more frequent in transitionalcell 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 highertumor grade, higher proliferation index, and recurrence. In the whole specimens, altered survivin expression was significantly associatedwith advanced stage (p<0.001), recurrence (p=0.005), distant metastasis (p<0.001), and death (p=0.001). In the multivariateanalysis, 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 frequentlyand is not associated with features of tumor aggression or patient outcome. These findings raise a question: are urinarybladder carcinoma patients with squamous cell carcinoma type suitable candidates for survivin vaccine? This is an important questionto be answered before approving the vaccine in management.

참고문헌 (Reference)

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