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VOLUME 20 , ISSUE 5 ( May, 2019 ) > List of Articles


Prognostic Implication of Survivin Expression in Oral Squamous Cell Carcinoma—An Immunohistochemical Study

M Ajithkumar, Chinnakonda Raveendranath Murali, Nandimandalam Venkata Vani

Keywords : Immunohistochemistry, Oral cancer, Prognostic marker, Survivin

Citation Information : Ajithkumar M, Murali CR, Vani NV. Prognostic Implication of Survivin Expression in Oral Squamous Cell Carcinoma—An Immunohistochemical Study. J Contemp Dent Pract 2019; 20 (5):577-581.

DOI: 10.5005/jp-journals-10024-2561

License: CC BY-NC 4.0

Published Online: 01-04-2015

Copyright Statement:  Copyright © 2019; The Author(s).


Aim: Immunohistochemical expression of survivin was analyzed among the three histological grades (well differentiated, moderately differentiated, and poorly differentiated) of oral squamous cell carcinoma (OSCC). Materials and methods: The study material consisted of 60 formalin-fixed paraffin-embedded tissue samples: 15 cases each of well, moderate, and poorly differentiated OSCC and normal oral mucosal (NOM) tissues as the control. Survivin expression was evaluated immunohistochemically and statistical analysis of data was performed using Fisher's Chi-square and analysis of variance (ANOVA) tests. Results: Survivin was expressed in all grades of OSCC, but absent in normal oral tissue samples. Poorly differentiated OSCC exhibited 51 to 75% immunopositivity (53.3%) and severe staining intensity (46.7%) for survivin, predominantly in nuclear areas. While moderately differentiated OSCC had 26 to 50% immunopositivity (40%) and moderate staining intensity (80%), 5 to 25% immunopositivity (40%) with moderate staining intensity (86.7%) was observed in well-differentiated OSCC. Overall, there was a statistically significant difference among the three grades of OSCC in relation to survivin immunopositivity and immunoreactivity (p < 0.01). Conclusion: This study supports the use of survivin as a potent diagnostic and prognostic marker for OSCC. Clinical significance: Increased survivin expression and its nuclear localization appeared to correlate with a higher grade of malignancy suggesting unfavorable prognosis.

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  1. Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 2009 Apr 1;45(4):309.316. DOI: 10.1016/j.oraloncology.2008.06.002.
  2. Conceicao Pereira M, Oliveira DT, et al. Histologic subtypes of oral squamous cell carcinoma: prognostic relevance. J Can Dent Assoc 2007 May 1;73(4):127.135.
  3. Jaiswal PK, Goel A, et al. Survivin: a molecular biomarker in cancer. Ind J Med Res 2015 Apr;141(4):389.397. DOI: 10.4103/0971- 5916.159250.
  4. Nakagawa K, Yamamura K, et al. bcl-2 expression in epidermal keratinocytic diseases. Cancer 1994 Sep 15;74(6):1720.1724.
  5. Muzio LL, Pannone G, et al. Survivin expression in oral squamous cell carcinoma. Br J Cancer 2003 Dec;89(12):2244.2248. DOI: 10.1038/sj.bjc.6601402.
  6. Rothenberg SM, Ellisen LW. The molecular pathogenesis of head and neck squamous cell carcinoma. J Clin Invest 2012 Jun 1;122(6):1951.1957.
  7. Perez-Sayans M, Somoza-Martin JM, et al. Genetic and molecular alterations associated with oral squamous cell cancer. Oncol Rep 2009 Dec 1;22(6):1277.1282.
  8. Ram H, Sarkar J, et al. Oral Cancer: Risk Factors and Molecular Pathogenesis. J Maxillofac Oral Surg 2011 Apr;10(2):132–137. DOI: 10.1007/s12663-011-0195-z.
  9. Williams HK. Molecular pathogenesis of oral squamous carcinoma. Mol Pathol 2000 Aug;53(4):165–172.
  10. Gayathri C, Rao GV. Immunohistochemical expression of Survivin in oral leukoplakia and oral squamous cell carcinoma. J Univ Health Sci 2017 Jan;6:39–44.
  11. Lin CY, Hung HC, et al. Survivin expression predicts poorer prognosis in patients with areca quid chewing-related oral squamous cell carcinoma in Taiwan. Oral Oncol 2005 Jul 1;41(6):645–654. DOI: 10.1016/j.oraloncology.2005.02.009.
  12. Khan Z, Khan AA, et al. Survivin, a molecular target for therapeutic interventions in squamous cell carcinoma. Cell Mol Biol Lett 2017 Dec;22(1):8. DOI: 10.1186/s11658-017-0038-0.
  13. Li SX, Chai L, et al. Expression of survivin and caspase 3 in oral squamous cell carcinoma and peritumoral tissue. Asian Pac J Cancer Prev 2012;13(10):5027–5031.
  14. Jinbu Y, Tsukinoki K, et al. Expression of survivin in oral squamous cell carcinoma. Oral Med Pathol 2006 Jun 25;11(2):41–44.
  15. Qi G, Kudo Y, et al. Nuclear Survivin expression is correlated with malignant behaviors of head and neck cancer together with Aurora-B. Oral Oncol 2010 Apr 1;46(4):263–270. DOI: 10.1016/j.oraloncology.2010.01.004.
  16. Muzio LL, Campisi G, et al. HPV DNA and survivin expression in epithelial oral carcinogenesis: a relationship? Oral Oncol 2004 Aug 1;40(7):736–741. DOI: 10.1016/j.oraloncology.2003.11.011.
  17. Negi A, Puri A, et al. Comparison of immunohistochemical expression of antiapoptotic protein survivin in normal oral mucosa, oral leukoplakia, and oral squamous cell carcinoma. Pathol Res Int 2015;2015:840739. DOI: 10.1155/2015/840739.
  18. Tanaka C, Uzawa K, et al. Expression of an inhibitor of apoptosis, survivin, in oral carcinogenesis. J Dent Res 2003 Aug;82(8):607–611. DOI: 10.1177/154405910308200807.
  19. Fukuda S, Pelus LM. Survivin, a cancer target with an emerging role in normal adult tissues. Mol Cancer Ther 2006 May 1;5(5):1087–1098. DOI: 10.1158/1535-7163.MCT-05-0375.
  20. Chaiyarit P, Jintakanon D, et al. Immunohistochemical analyses of survivin and heat shock protein 90 expression in patients with oral lichen planus. J Oral Pathol Med 2009 Jan;38(1):55.62. DOI: 10.1111/j.1600-0714.2008.00713.x.
  21. Lippert BM, Knauer SK, et al. Dynamic survivin in head and neck cancer: molecular mechanism and therapeutic potential. Int J Cancer 2007 Sep 15;121(6):1169.1174. DOI: 10.1002/ijc.22941.
  22. Li F, Yang J, et al. Nuclear or cytoplasmic expression of survivin: what is the significance? Int J Cancer 2005 Apr 20;114(4):509.512. DOI: 10.1002/ijc.20768.
  23. Pannone G, Bufo P, et al. Survivin phosphorylation and M-phase promoting factor in oral carcinogenesis. Histol Histopathol 2007 Nov 1;22(10/12):1241.1249. DOI: 10.14670/HH-22.1241.
  24. Jane C, Nerurkar AV, et al. Increased survivin expression in high-grade oral squamous cell carcinoma: a study in Indian tobacco chewers. J Oral Pathol Med 2006 Nov;35(10):595.601. DOI: 10.1111/j.1600- 0714.2006.00473.x.
  25. Preuss SF, Weinell A, et al. Nuclear survivin expression is associated with HPV-independent carcinogenesis and is an indicator of poor prognosis in oropharyngeal cancer. Br J Cancer 2008 Feb;98(3): 627.632. DOI: 10.1038/sj.bjc.6604192.
  26. Ciesielski MJ, Qiu J, et al. Survivin as a cancer vaccine target. J Vaccines Vaccin 2014 May;5(3):230.236.
  27. Liping S, Ying W, et al. Up-regulation of survivin in oral squamous cell carcinoma correlates with poor prognosis and chemoresistance. Oral Surg, Oral Med, Oral Pathol, Oral Radiol Endodontol 2010 Oct 1;110(4): 484.491. DOI: 10.1016/j.tripleo.2010.04.009.
  28. Tu SP, Jiang XH, et al. Suppression of survivin expression inhibits in vivo tumorigenicity and angiogenesis in gastric cancer. Cancer Res 2003 Nov 15;63(22):7724.7732.
  29. Mesri M, Wall NR, et al. Cancer gene therapy using a survivin mutant adenovirus. J Clin Invest 2001 Oct 1;108(7):981.990. DOI: 10.1172/JCI12983.
  30. Mobahat M, Narendran A, et al. Survivin as a Preferential Target for Cancer Therapy. Int J Mol Sci 2014 Feb 13;15(2):2494.2516. DOI: 10.3390/ijms15022494.
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