Survivin expression is associated with features of biologically aggressive prostate carcinoma

BACKGROUND Survivin counteracts cell death and controls mitotic progression. The objectives of the current study were to compare the expression patterns of survivin in normal prostate, primary prostate carcinoma, and lymph node tissues involved with prostate carcinoma and to determine whether the expression of survivin is associated with prostate carcinoma characteristics and progression. METHODS Immunohistochemical staining for survivin and for transforming growth factor β1 (TGF‐β1) and its receptors (types I and II; TGF‐βR1 and TGF‐βR2, respectively) was carried out on archival specimens from 114 consecutive patients who underwent radical prostatectomy (median follow‐up, 64.8 months). Punch biopsies of the index carcinoma and normal tissue from each specimen were sectioned onto a single slide and stained. The authors also evaluated the expression of survivin in normal and malignant lymph node tissue from eight patients. RESULTS Survivin was expressed in 41 of 114 normal prostate specimens (36%) from prostates that contained carcinoma, in 81 of 114 primary prostate carcinoma specimens (71%), in 3of 8 normal lymphoid specimens (38%), and in 7 of 8 prostate carcinoma lymphoid specimens (88%). Survivin expression was associated with higher final Gleason sum (P = 0.001), loss of TGF‐βR1 and TGF‐βR2 expression (P = 0.041 and P = 0.008, respectively), and an increased risk of biochemical progression on univariate analysis (P = 0.0441). Among patients who had disease progression, survivin was expressed more commonly in those who had tumors with features of aggressive behavior. CONCLUSIONS The expression of survivin gradually increased from normal prostate tissue, to low‐grade primary carcinoma, to high‐grade primary carcinoma and was highest in lymph node metastases. Survivin expression was associated further with alteration of the TGF‐β pathway and with overall and aggressive biochemical progression after radical prostatectomy. Cancer 2004;100:751–7. © 2004 American Cancer Society. Survivin is a novel regulator of apoptosis by counteracting cell death and controlling mitotic progression. The authors found that survivin expression increased markedly from normal prostate specimens to primary carcinoma tissue, and was highest in cancerous lymph node tissue. Altered survivin expression was associated with higher Gleason sum, loss of expression of TGF‐BR1 and R21 and an increased risk of experiencing biochemical progression after radical prostatectomy.