Tonini G et al. (2005) Nuclear and cytoplasmic expression of survivin in 67 surgically resected pancreatic cancer patients. Br J Cancer 92: 2225–2232

Pancreatic tumors are generally resistant to conventional chemoprevention therapies, and pancreatic cancer is associated with poor long-term survival. The role of apoptosis and inhibitors of the apoptotic proteins in pancreatic cancer carcinogenesis has not been clearly defined. Tonini and colleagues have started to address this issue by evaluating the role of the expression of the apoptotic inhibitor protein survivin (and its cellular distribution) and cyclooxygenase 2 (COX2) expression in the prognosis of pancreatic cancer.

In total, tumor specimens from 67 patients who had undergone radical surgery for pancreatic adenocarcinoma were eligible for inclusion in the study. Immunohistochemical techniques were used to determine the expression of survivin and COX2, and TUNEL staining was used to identify apoptotic cells.

The results demonstrated that the cellular location of survivin determined its prognostic effect, in that a significantly more favorable prognosis was associated with nuclear overexpression, whereas cytoplasmic overexpression conferred a negative prognosis (P = 0.0009). The apoptotic index, on univariate analysis, was also found to be a significant prognostic factor for longer survival. Conversely, however, COX2 expression was not found to be of prognostic value in these patients.

The authors conclude that their study is the first to demonstrate the importance of the cellular distribution of survivin overexpression in the prognosis of patients with pancreatic cancer.