High survivin expression in premalignant and malignant kidney lesions

Background Survivin is a recently identified member of the inhibitor of apoptosis family that has been implicated both in regulating mitotic progression and in suppressing apoptosis. Survivin is commonly expressed in fetal cells and in virtually all human malignancies but is undetectable in most differentiated adult normal tissues. Objective The aim of the present study was to investigate the expression of survivin protein in normal kidney, pyelonephritic kidney, renal intratubular neoplasia (RIN), and renal cell carcinoma (RCC) tissues and its correlation with different clinicopathological parameters. Methods Immunohistochemical staining for survivin was carried out on archival paraffin blocks from 40 consecutive patients who underwent nephrectomy for RCC, as well as from 25 pyelonephritic kidneys, 10 normal kidneys, and 14 cases of RIN. Results Survivin protein was expressed in 29 of the 40 (72.5%) cases of RCC compared with its expression in nine of 14 (64.3%) cases of RIN; this difference was statistically insignificant. The positive rate of survivin was strongly associated with pathological grades, clinical stages, and lymph metastasis in RCC ( P <0.05). In contrast, normal and pyelonephritic renal tissues did not express survivin. Conclusion Apoptosis inhibition by survivin may participate in the onset and progression of RCC. The detection of survivin protein in RCC may help to evaluate the degree of cell differentiation and depth of invasion, decide therapeutic strategies and estimate prognosis, and may be a potential target for apoptosis-based therapy.