Potential Prognosis of Survivin in Epidermoid Carcinoma of the Oral Cavity
Name: PAOLA FERNANDES PANSINI
Publication date: 15/02/2017
Advisor:
Name |
Role |
|---|---|
| SANDRA LÚCIA VENTORIN VON ZEIDLER | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| FLAVIA DE PAULA (M/D) | Internal Examiner * |
| SANDRA LÚCIA VENTORIN VON ZEIDLER | Advisor * |
Summary: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer in the world. In recent years, the participation of survivin in tumor progression in HNSCC has been suggested. This study aimed to evaluate survivin as a potential biomarker of tumor progression in oral squamous cell carcinoma (OSCC). Clinical data and biological samples from 115 individuals with OSCC were used in the study. Slides containing tumor tissues stained with hematoxylin and eosin were used for histopathological analysis to evaluate tumor lymphocyte infiltrate, tumor invasion pattern, tumor grade, vascular, lymphatic and perineural invasion. Tissue microarrays were constructed to perform the immunohistochemical analysis of survivin protein expression using the rabbit anti-survivin monoclonal primary antibody. To evaluate the associations between the studied variables were used Chi-Square and Fisher's Exact tests. The comparison of the means of the segments was obtained by the T test of independent samples. The survival curves were calculated by the Kaplan-Meier model and confirmed by the Cox multivariate model. Our results showed a correlation between the high tumor lymphocyte infiltrate, primary tumor size T1 / T2 (p = 0.001) and clinical stage I and II (p = 0.005). The type IV tumor invasion pattern was correlated with T3 / T4 primary tumor size (p = 0.006) and advanced clinical staging (stage III and IV) (p = 0.028). Perineural invasion was associated with T1 / T2 primary tumor size (p = 0.035). Nuclear expression of survivin in the median portion of the tumor showed association with regional lymph node metastasis (p = 0.004) and clinical staging (p = 0.041). The multivariate regression analysis confirmed that the variables primary tumor size (p = 0.004) and lymph node involvement (p = 0.06) were independent prognostic factors for overall survival, while alcoholism influenced disease-free survival (p = 0.048). This study concludes that the high expression of survivin is correlated with the most aggressive tumor behavior, advanced clinical staging, presence of lymph node metastasis, can be considered as an indicator of prognosis in patients with OSCC. The standard histopathological variable of tumor invasion showed that its correlation with primary tumor size and advanced clinical staging could be related to the worse prognosis of the patients in OSCC.
