Survivin gene expression in chronic liver disease and hepatocellular carcinoma

Background/Aims: Survivin is an oncofetal protein involved both in cell death and cell cycle regulation. Survivin is undetectable or found at very low levels in normal differentiated tissues whereas increased expression has been observed in several human malignancies, including lung, colon and liver cancer. The aim of this study was to evaluate the diagnostic and clinical significance of Survivin expression in hepatocellular carcinoma and non-neoplastic liver tissues in a series of surgical patients. Methodology: Survivin mRNA levels were quantitated by real time RT-PCR in 25 patients. Results: Survivin mRNA was documented in all liver tissues with significantly higher levels in neo-plastic specimens (p=0.01). In non-neoplastic liver tissue, Survivin levels were correlated with activity score of chronic liver disease. Increased Survivin levels were correlated with high tumor grade (p=0.05) and vascular invasion (P=0.005). Tumor recurrences were more frequent in patients with high Survivin levels, although the difference did not reach statistical significance. Conclusions: Low levels of Survivin mRNA are present in normal and in non-neoplastic liver tissue. In hepatocellular carcinomas, high levels of Survivin are associated with aggressive tumor features. The prognostic significance of quantitative Survivin evaluation requires further studies.