Expression of the apoptosis inhibitor protein Survivin in primary laryngeal carcinoma and cervical lymph node metastasis.

BACKGROUND: Survivin is the smallest mammalian member of the inhibitor of apoptosis (IAP) proteins family. The aim of the present study was to determine survivin expression in laryngeal squamous cell carcinoma (SCC) and in neck lymph node metastases. The survivin value in predicting prognosis in laryngeal SCC was also investigated. PATIENTS AND METHODS: Survivin expression was investigated in 37 laryngeal SCCs and in 12 cervical lymph node metastases. RESULTS: A nuclear reaction predominated in laryngeal SCCs. Survivin expression was significantly higher in pN+ laryngeal SCCs than in pN0 (p = 0.017). Survivin expression was higher in cervical lymph node metastases than in correspondent primary laryngeal SCCs (p = 0.002). Survivin expression in laryngeal SCCs that developed loco-regional recurrence was significantly higher than in laryngeal SCCs without recurrence of disease (p = 0.039). CONCLUSION: Nuclear expression of survivin should be studied as a hallmark of higher risk laryngeal SCCs to develop loco-regional recurrences. Higher survivin expression in pN+ laryngeal SCC may suggest elective neck dissection in clinically N0 patients with high survivin expression in primary SCC. The extremely high survivin expression in lymph node metastases may support the use of survivin in the diagnosis of lymph node micro-metastases.