Expression And Clinicopathological Significance Of Antiapoptotis Protein Survivin In Gallbladder Cancer

Background: Clinical significance of survivin (antiapoptosis protein) in gallbladder cancer is not yet established. Aims: This study was performed to assess the expression pattern of survivin in benign and malignant gallbladder lesions using immunohistochemistry (IHC), and to assess its clinicopathological significance. Settings and Design: Prospective study from July 2012 to July 2014 was performed as a part of intramural research project. Materials and Methods: Tissue samples from resected gallbladder for cholelithiasis (n = 27) and carcinoma gallbladder (n = 24) were evaluated for survivin expression by IHC using a scoring system. Their expression was correlated with different clinicopathological parameters. Statistical Analysis: Fisher's exact test, Student's t-test, and Chi-square test were used as appropriate for data analysis. Kaplan-Meier methods were used to calculate overall and disease-free survival rates among different groups. Two-sided P < 0.05 was considered as significant. Results: Benign group (19 females, age [mean +/- standard deviation [SD]] 45 +/- 14 years) and malignant group (20 females, age [mean +/- SD] 48.9 +/- 13.4 years) were comparable with respect to menopausal status, presence, size and types of stones. However, survivin expression was significantly higher (66.7%, 95% confidence interval [CI] 24-75) in gallbladder cancer than in cholelithiasis group (33%, CI 46-83), P = 0.025). Its expression did not correlate with gender, age, menopausal status, presence of gallstones or their size, number and type, tumor differentiation, and tumor stage. Conclusions: Significantly higher expression of survivin protein in gallbladder cancer as compared to cholelithiasis group suggests its role in gallbladder carcinogenesis though it may not have prognostic value.