Survivin expression and its clinical significance in pancreatic cancer

We performed immunohistochemical staining for survivin, p53, and Bax in formalin-fixed, paraffin-embedded block from forty-nine pancreatic tissues. To determine the association with clinical course, we reviewed the patients' clinical record.Of the 49 cases of pancreatic cancer, 46 cases (93.9%) were positive for survivin expression. There was no significant association between survivin expression and p53 or bax. For clinicopathological parameters, perineural invasion was more common in survivin positive and venous invasion was more common in survivin negative (p = 0.041 and 0.040, respectively). Responsiveness to chemotherapy appeared to be slightly better in patients with low survivin expression.Survivin expression may be associated with venous or perineural invasion, indicating metastatic route, and seems to have a potential as a predictive marker for chemotherapy. Further study of large scale is required to determine the clinical significance of survivin expression in pancreatic cancer.Survivin has recently been identified as a novel inhibitor of apoptosis (IAP). It blocks common downstream elements of both the mitochondrial pathway and the death receptor pathway, by directly inhibiting terminal effector caspase-3, caspase-7, and caspase-9 activity[1,2]. Thus, it inhibits apoptosis pathway differently from bcl-2, which blocks mitochondrial cytochrome c release into the cytosol, resulting in the inhibition of mitochondrial apoptotic pathway. Survivin is expressed during embryonic and fetal development but is undetectable in terminally differentiated normal adult tissue. However, it is re-expressed in transformed cell lines and several human cancer cells at a frequency of 34–100 % [3,4]. As a prognostic factor, survivin expression is significantly associated with poor clinical outcome in cancers, such as neuroblastoma, colorectal cancer, breast cancer, lung cancer and esophageal cancer [5-10].Survivin expression in pancreatic cancer has not been widely studied. Sat