Prognostic Significance of Survivin and Nuclear Morphometry in Nasopharyngeal Carcinoma

Purpose: American Joint Committee on Cancer (AJCC) TNM staging system has been widely used for prognosis prediction of nasopharyngeal carcinoma (NPC) patients. Although NPC patients can be classified according to their clinical stage in this system, their prognosis may vary significantly. Therefore, it is important to search for novel molecular biomarkers, which can help in improvement of the prognostic prediction. So, this study aimed to evaluate survivin expression and assessment of nuclear morphometric features of nasopharyngeal carcinoma to investigate their prognostic significance. Material and Methods: Forty nine cases of nasopharyngeal carcinoma (NPC) with clinical follow-up data were collected and expressions of survivin in tumor tissues were investigated by immunohistochemistry (IHC). Nuclear Morphometry was also studied for all cases. Results: Patients’ follow-up revealed 30 cases (61.2%) developed lymph node metastasis, 18 (36.7%) developed distant metastasis, among them 13 (63.3%) died. Survivin expression was significantly correlated with TNM stage of nasopharyngeal carcinoma (NPC). Patients with low survivin expression had better 3-year survival rate than the group with high survivin expression (75% vs. 25%, respectively, p 0.05). Mean nuclear area in cases with low survivin expression was 37.88, which was significantly lower than that in those with survivin over-expression (52.81) (p 0.05). Conclusion: Nasopharyngeal carcinoma cases express high survivin levels, which may play an important role in tumor progression. Survivin over-expression and high mean nuclear area (MNA) were associated with poor prognosis. So, we suggest that determination of tumor survivin expression and MNA may provide valuable predictive informations on NPC patients.