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Survivin, a Potential Early Predictor of Tumor Progression in the Oral Mucosa

¹ Institute of Dental Sciences, Faculty of Medicine, University of Ancona, Ancona, Italy;
² Department of Biomorphological and Functional Sciences, Pathology Unit, Faculty of Medicine, University of Naples Federico II, Naples, Italy;
³ Institute of Dental Sciences, University of Catania, Catania, Italy;
⁴ Department of Dental Sciences and Maxillofacial Surgery, Faculty of Medicine, University of Naples Federico II, Naples, Italy;
⁵ Department of Oral Pathology, Faculty of Dentistry, Hiroshima University, Hiroshima, Japan; and
⁶ Department of Cancer & Biology and the Cancer Center, Medical School, University of Massachusetts, Worcester, USA;

^* corresponding author, Via Carelli 28, 71100 Foggia, Italy, lomuziol{at}tin.it or llomuzio{at}tin.it

Survivin is a recently described apoptosis inhibitor selectively over-expressed in most tumors. Immunohistochemistry was used to investigate a potential role of survivin as an early predictor of malignant transformation in precancerous and cancerous lesions of the oral cavity. Survivin was present in 10/30 cases (33%) of oral precancerous lesions without malignant progression, and in 15/16 cases (94%) of oral precancerous lesions evolved into full-blown squamous cell carcinoma. Tumors that progressed from these precancerous lesions retained widespread survivin positivity (100%). Variations among group means were highly statistically significant (p < 0.001). No significant correlation was found between survivin expression and the degree of dysplasia. High expression of cytoplasmic/nuclear survivin is an early event during oral carcinogenesis and may provide a useful tool for the identification of precancerous lesions at higher risk of progression into invasive carcinoma.

KEY WORDS: survivin • precancerous lesion • IAP • oral squamous cell carcinoma • apoptosis

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