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Survivin mRNA expression is elevated in malignant urothelial cell carcinomas and predicts time to recurrence
I J Schultz1, L A Kiemeney, J A Witjes
1Department of Clinical Chemistry/564, University Medical Center Nijmegen, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. i.schultz@akc.umcn.nl
Background:
Expression of the inhibitor of apoptosis protein survivin is up-regulated in many tumors of epithelial origin and frequently shows a relationship with disease prognosis.
Materials And Methods:
We investigated survivin mRNA expression in 32 urothelial cell carcinomas by use of real-time quantitative PCR. Expression values were normalized to transcript levels of the housekeeping gene cyclophilin.
Results:
All bladder tumor tissues expressed survivin mRNA. The median normalized survivin mRNA expression values were 0.26 for superficial tumors (n = 17) and 0.78 for invasive tumors (n = 15). A significant relationship with increasing pathological stage (p < 0.001) and grade (p < 0.001) was observed. Although survivin mRNA expression did not relate to disease progression or the patient survival period, patients with superficial bladder tumors and normalized survivin values over 0.26 had an increased risk of recurrence (log-rank test: p = 0.018).
Conclusion:
Our results suggest that quantitative measurement of survivin mRNA 1) can identify invasive and high-grade urothelial cell carcinomas and 2) may be used as an indicator for early recurrence of superficial tumors.