1. ¹Institute of Dental Sciences, Faculty of Medicine, University of Ancona, Ancona, Italy
2. ²Department of Biomorphological and Functional Sciences, Pathology Unit, Faculty of Medicine, University of Naples Federico II, Naples, Italy
3. ³Department of Dental Sciences, Faculty of Medicine, University of Naples Federico II, Naples, Italy
4. ⁴Institute of Pathology, University of Ancona, Ancona, Italy
5. ⁵Department of Biomedical Sciences and Human Oncology – Section of General Pathology and Experimental Oncology, University of Bari, Bari, Italy
6. ⁶Department of Cancer Bioilogy and the Cancer Center, University of Massachusetts Medical School, Worcester, MA 01605, USA

Correspondence: Prof L Lo Muzio, Institute of Dental Sciences, Faculty of Medicine, University of Ancona, Via Carelli 28, 71100 Foggia, Italy. E-mail: llomuzio@tin.it

Revised 5 September 2003; Accepted 16 September 2003.

Abstract

A series of 110 cases of oral squamous cell carcinoma (SCC) together with six lymph node and one distant metastatic lesions was analysed for expression of survivin, a recent apoptosis inhibitor, by immunohistochemistry and Western blotting. In total, 91 cases (82.7%) of carcinoma and all metastasis (seven cases, 100%) were positive for survivin expression, with weighted survivin scores ranging from 1 to 4. In contrast, normal oral epithelium did not express survivin. There was no significant correlation between survivin expression and age, sex, tumour size, the presence of lymph node and distant metastases. Survivin expression was increased in poorly differentiated tumours, even if differences were not statistically significant. In contrast, when analysed for prognostic significance, patients with low survivin expression had statistically significant better survival rates than the group with high survivin expression (P<0.05). These data suggest that survivin expression may identify cases of oral SCC with more aggressive and invasive phenotype.