Survivin and Ki-67 immunohistochemical expression in penile squamous cell carcinoma: clinicopathological features and...

The present study evaluated Survivin and Ki-67 immunohistochemical expression in squamous cell carcinoma of the penis and its association with clinicopathological features and outcomes.

A retrospective cohort study, from 1998 to 2016, was conducted at a tertiary hospital in Brazil, utilizing a convenience sample. The study collected clinical characteristics, pathological features, and outcomes. Immunohistochemical expressions of Survivin and Ki-67 were performed on formalin-fixed paraffin-embedded specimens from patients with PSCC. Survivin positivity (Survivin +) was defined as any staining in more than 5% of tumor cells, while Ki-67 positivity was defined as any staining in more than 10%. The Mann-Whitney U test and Fisher's exact test were used to perform the associations. Kaplan-Meier curves with log-rank were used to estimate survival.

Forty patients undergoing partial or total penectomy were selected, with five subsequently excluded. Among the remaining 35 patients, 15 (42.8%) were Ki-67 positive, and 9 (25.7%) were Survivin + . Ki-67 expression did not demonstrate association with higher tumor grade (73.3% for grades II and III vs. 55% for grade II in the Ki-67 < 10% group; p = 0.06), larger lesions (p = 0.05), or survival outcomes (HR 1.66; 95% CI 0.56-4.98; p = 0.36). Survivin + was more common in grade II and III than grade I (77.8% vs. 22.1; p = 0.027), and Survivin + patients were correlated with worse overall survival (HR 3.73; 95%CI 1.25-11.12; p = 0.01).

Ki-67 expression does not seem to have an impact on clinicopathological features and overall survival. The expression of survivin seems to be promising in detecting penile squamous cell carcinoma patients with a worse prognosis.