Nuclear survivin expression correlates with endoglin-assessed microvascularization in laryngeal carcinoma

Aims. Survivin - a member of the family of inhibitor of apoptosis proteins that control cell division, apoptosis, and metastasis - is overexpressed in virtually all human cancers, including laryngeal squamous cell carcinoma (LSCC). Recent findings also correlate survivin expression with the regulation ofangiogenesis. The novel main aim of the present study was a preliminaryinvestigation into the potential role of survivin expression in LSCCneoangiogenesis, as determined by endoglin-assessed microvascular density (MVD). Methods. Immunohistochemical expression of nuclear survivin and endoglin-assessedMVD were ascertained by image analysis in 75 consecutive LSCCs. Results. Statistical analysis disclosed a strong direct correlation between nuclear survivin expression and MVD. Patients whose nuclear survivin expression was ≥6.0% had a significantly higher LSCC recurrence rate, and a significantly shorter disease-free survival (DFS) than those with a nuclear survivin expression <6.0%. The LSCC recurrence rate was also higher and the DFS shorter in patients with endoglin-assessedMVD ≥6.89%. The odds ratio (OR) for recurrence was 2.79 in LSCCpatients with a nuclear survivin expression ≥6.0%, and 12.31 in those with a MVD≥6.89%. Conclusions. Survivin-targeting strategies to enhance tumor cell response to apoptosis and inhibit tumor growth should receive more attention with a view to developing agents for use in multimodality advanced LSCC treatment, or combined with conventional chemotherapy. Given the present preliminary evidence in LSCC, survivin targeting should also be further investigated for anti-angiogenic purposes, to reduce tumor blood flow and induce cancer necrosis.