Influence of Survivin and Caspase-3 on Cell Apoptosis and Prognosis in Gastric Carcinoma

AIM: To evaluate the role of survivin and caspase-3 in apoptosis of gastric carcinoma, as well as in prognosis of patients with gastric carcinoma. METHODS: Expressions of survivin and caspase-3 were investigated immunohistochemically in 80 gastric carcinoma patients without a history of chemo-radiation therapy. Tumor cell apoptosis was examined by TUNEL method. RESULTS: Immunohistochemical analysis showed that survivin expression was positive in 61 of 80 patients (76%) with gastric carcinoma. In contrast, no expression of survivin in adjacent normal tissues was detected. Expression level of caspase-3 was higher in normal tissues than in carcinoma. Patients with higher expression of survivin had worse histological grades and pathological stages. Expression of caspase-3 was significantly associated with histological stages, but not with the pathological stages. Although survivin expression in carcinoma was not inversely related to caspase-3, patients with survivin (-) and caspase-3(+) had the maximum apoptosis index. CONCLUSION: Expression level of survivin was associated with histological grades and pathological stages of the tumor, indicating that survivin may be a poor prognosis factor for gastric carcinoma. Unlike caspase-3, survivin (an apoptosis inhibitor) can markedly inhibit the apoptosis of tumor cells.