THE CLINICAL SIGNIFICANCE OF SURVIVIN AND VASCULAR ENDOTHELIAL GROWTH FACTOR IN BREAST CANCER AND PRECANCEROUS LESIONS

Abstract

Methods: Immunohistochemical Ultra Sensitive? S-P method was employed to detect the expression of Survivin and VEGF in 334 cases, including 60 cases of UDH, 57 cases of atypical ductal hyperplasia (ADH), 89 cases of ductal carcinoma in situ (DCIS), and 128 cases of invasive ductal carcinomas (IDC). Multiple biological parameters, including tumor size, grade, lymph node status, tumor metastasis, and stage, were compared to investigate the associations of Survivin and VEGF expressions in breast carcinoma. Results: (1) Survivin was mainly distributed in cytoplasm in UDH, but also distributed in nucleus and cytoplasm in IDC, DCIS, and ADH mammary tissues. (2) The positive rates of Survivin and VEGF in IDC were 67.2% and 68.8%, in DCIS were 59.6% and 44.9%, in ADH were 57.9% and 36.8%, and in UDH tissues were 1.7% and 20.0%. Compared with UDH tissues, there were significant differences in the positive rates of Survivin and VEGF in IDC (χ2=70.540, P=0.000; χ2=38.993, P=0.000), DCIS (χ2=51.967, P=0.000; χ2=9.815, P=0.002), and ADH (χ2=42.829, P=0.000; χ2=4.095, P=0.043), P<0.05, respectively. There were significant differences in the positive expression rates of VEGF between DCIS and IDC (χ2=12.298, P=0.001), and ADH and IDC (χ2=16.589, P=0.000); however, there were no significant differences in Survivin expression between IDC and DCIS (χ2=1.330, P=0.249), and IDC and ADH tissue (χ2=1.484, P=0.223). Positive expression rates of Survivin and VEGF showed no significant differences between ADH and DCIS tissue (χ2=0.039, P=0.843; χ2=0.938, P=0.333). (3) There was a positive correlation in over-expressions of Survivin and VEGF with histological grade (χ2=10.631, 12.412), lymph node metastasis (χ2=8.135, 7.677), distant metastasis (χ2=17.732, 7.621), and stage (χ2=6.992, 21.211) of IDC tumors. (4) The expression of VEGF was positively correlated with Survivin (r=0.211, P=0.017). Conclusion: The results demonstrate that the change in Survivin location from cytoplasm to nucleus might participate in oncogenesis and development of breast cancer. Over-expression of Survivin and VEGF might be important biological markers for invasion and metastasis of breast invasive carcinomas. Combined detection of Survivin and VEGF can serve as predictors for prognosis of breast carcinoma.