Study of the expression of Survivin in relation to E-Cadherin and their significance in colorectal carcinoma. An immunohistochemical and clinicopathological study

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ObjectiveSeveral therapeutic modalities have been used in the treatment of colorectal carcinoma (CRC); however, a complete cure has not been achieved. The development of CRC involves accumulated genetic alterations with progressive inhibition of apoptosis and increased tumor cell invasion. The expression of Survivin, a member of the inhibitor of apoptosis protein family, and E-Cadherin, the prime mediator of epithelial intercellular adhesion, has been studied in different malignancies. Here, we study their expression in colorectal adenocarcinoma sections in relation to different clinicopathological parameters including the length of progression-free survival.MethodsImmunohistochemical staining for Survivin and E-Cadherin was carried out on paraffin-embedded tissue sections. The results were statistically correlated with different clinicopathological parameters and the length of progression-free survival.ResultsThis retrospective study included 44 patients of colorectal adenocarcinoma. Of these, 14 (31.8%) men and 30 (68.2%) women were operated upon for CRC, with ages ranging between 26 and 80 years (mean 57.27±14.08 years). Survivin was expressed in all sampled cases (100%). Cytoplasmic Survivin staining was detected in 42 cases (95.5%) versus only two cases (4.5%) showing nuclear expression. E-Cadherin staining was positive in 42 cases (95.5%), with cytoplasmic expression in 24 cases (54.5%) and both membranous and cytoplasmic expression in 14 cases (31.8%). Neither Survivin nor E-Cadherin demonstrated a statistically significant relation to any of the clinicopathological parameters studied. The expression of E-Cadherin tended to increase as that of Survivin increased, (Spearman ρ=0.28, P=0.06). Survivin and E-Cadherin expression scores were not related to the length of progression-free survival; however, E-Cadherin cytoplasmic expression was statistically related (P=0.02) to longer progression-free survival unlike any studied pattern of Survivin expression.ConclusionSurvivin was expressed in all studied cases of CRC. The expression of E-Cadherin does not decrease but shifts from the membrane to the cytoplasm. Neither Survivin nor E-Cadherin expression correlated with clinicopathological parameters. There is a significant correlation between cytoplasmic expression of E- Cadherin (but not Survivin) and longer disease-free survival. The expression of Survivin tended to correlate with that of E-Cadherin.

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