A novel anti-apoptosis gene: Re-expression of survivin messenger RNA as a prognosis marker in non-small-cell lung cancers

Purpose: The survivin gene is a novel apoptosis inhibitor, related to the b aculovirus gene, which is believed to play a pivotal role in fetal developm ent and in cancer. We hypothesised that survivin would be expressed in tumo rs of patients with non-small-cell lung cancer (NSCLC), and we attempted to determine the influence of survivin re-expression on clinical outcome in p atients with up to stage IIIA NSCLC who had undergone radical surgery, Methods: We designed a reverse transcriptase polymerase chain reaction (RT- PCR) assay to study the expression of the survivin gene in 83 NSCLC tumor s amples and compared the results with relevant clinical and pathologic data. Results: The RT PCR identified survivin gene transcript in 71 (85.5%) of th e tumor samples and in only 10 (12%) of the paired, histopathologically nor mal lung samples. There was no relationship between histologic subtype (squ amous v nonsquamous) and survivin gene expression. The 12 patients without survivin expression had significantly better overall survival than the 71 p atients with survivin expression (P = .01 by univariate analysis; relative risk, 2.1), There was no significant correlation between survivin expressio n and age, sex, cigarette smoking, histologic subtype, tumor differentiatio n, tumor size, or the presence of mediastinal lymph node metastases in surg ical specimens, Conclusion: The survivin gene was expressed in a vast majority of NSCLC tum ors, We conclude that survivin transcript is a defining diagnostic marker f or NSCLC that may also yield prognostic information and, as an apoptosis in hibitor, be an important target in cancer therapy. (C) 1999 by American Soc iety of Clinical Oncology.