The anti-apoptotic protein survivin can improve the prognostication of meningioma patients

Abstract

BackgroundThe 2016 WHO histopathological grading includes a substantial within-variation in recurrence risk, and is thus insufficient to predict prognosis after initial surgery of patients suffering from meningiomas. The aim of this study was to compare the prognostic value of the histopathological grading and the conventional biomarker MIB-1 with expression of the anti-apoptotic protein survivin to see if this biomarker could complement recurrence prediction.MethodsUsing immunohistochemistry, the expression of MIB-1 and survivin were determined as labeling indices (LIs) in tissue micro arrays from 160 human meningiomas. The accuracy of prognostication was assessed with receiver operator characteristics analyses and standard survival analyses.ResultsThe expression of survivin was significantly associated with both histopathological grade (P = 0.022) and recurrence status (P = 0.035). A survivin LI of 1% was identified as the optimal cutoff value to predict recurrence (P = 0.003), and was proven as more reliable than the histopathological grading (P = 0.497) and MIB-1 expression (P = 0.091). This result was further strengthened in multivariate analyses where survivin expression was revealed as an independent predictor of recurrence-free survival, while the histopathological grading and MIB-1 expression did not reach significance (P ≥ 0.156).ConclusionsThese findings suggest that incorporation of survivin in the clinical practice might be useful as complement for the histopathological grading and should further be evaluated in independent prospective studies.

The expression of survivin in irreversible pulmonary arterial hypertension rats and its value in evaluating the reversibility of pulmonary arterial hypertension secondary to congenital heart disease

“…found that the expression of survivin measured by immunohistochemical staining was significantly associated with a histopathological grade in meningiomas. 19 In a comprehensive analysis on the effect of survivin on the prognostic and clinicopathological significance in patients with renal cell carcinoma, Xie et al. found that high survivin expression was significantly associated with the TNM stage, pathological T stage, and tumor size.…”

“…Winther et al found that the expression of survivin measured by immunohistochemical staining was significantly associated with a histopathological grade in meningiomas. 19 In a comprehensive analysis on the effect of survivin on the prognostic and clinicopathological significance in patients with renal cell carcinoma, Xie et al found that high survivin expression was significantly associated with the TNM stage, pathological T stage, and tumor size. 20 The current experiment showed that the survivin increased in pulmonary arteries suffering from neointimal lesions in irreversible PAH rats but remained unchanged in pulmonary arteries showing medial hypertrophy from reversible PAH rats, even if the mPAP was elevated significantly.…”

Malignant meningioma

“…Several other immunohistochemical markers of proliferating cells are known, including proliferating cell nuclear antigen (PCNA) 136,137 and Survivin, [138][139][140] amongst others, such as Cyclin D1 and cyclin-dependant kinases. 141,142 But by far, Ki-67 expression is the proliferative marker most studied in meningioma.…”