Abstract Object: Gliomas are among the most aggressive of all human malignancies. Glioblastoma multiforme is the most malignant histo-pathological subtype. Survivin is one of the inhibitors of apoptosis. It is over-expressed in many human cancers. We performed clinical and pathological study aimed to clarify its role in glioma progression.
Methods: This study included 34 glioma patients. Clinical evaluation including age, sex, clinical presentation and location of the tumor, was done. Sections from glioma specimens were stained with H&E, classified and graded according to WHO classification, (2000) and then immunostained to detect Survivin protein expression.
Results: The study included 34 glioma cases. Survivin was expressed to a variable extent in most groups of gliomas (in 21/24, 1/4, 1/1 and 5/5 cases of astrocytomas, oligodendrogliomas, mixed oligoastrocytoma and ependymomas respectively). Survivin expression showed gradual up-regulation with increasing grade of astrocytomas from pilocytic astrocytomas (66.7%) → diffuse astrocytomas (77.8%) → anaplastic astrocytomas (100%) → glioblastoma multiforme (100%). This study showed that there is a strong correlation between the distribution and staining intensity of Survivin protein expression and the tumor grade (P< value< 0.01 and < 0.00 respectively). Also there is a strong correlation between Survivin protein expression as evidenced by immunoreactivity score (IRS) and tumor grade and proliferative activity (P value< 0.00 & <0.002 respectively).
Conclusion: Survivin plays an important role in the initiation of gliomas and their progression towards higher grades