Expression of Survivin in Colorectal Adenocarcinomas and Its Clinico-Pathological Correlation

Brihadisvarar, S (2017) Expression of Survivin in Colorectal Adenocarcinomas and Its Clinico-Pathological Correlation. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: “To live is to incur the risk of cancer”. Never has a disease instilled fear in the minds of common man and spiked the interests of researchers as cancer, both eagerly looking for a cure to this dreadful disease that not only causes mortality but also emotional and mental agony and suffering. Cancers figure among the leading causes of morbidity and mortality worldwide with approximately 14 million new cases and 8.2 million cancer related deaths in 2012. Colorectal cancer is the second most commonly diagnosed malignancy among women, the third most commonly diagnosed malignancy among men and the fourth most common cause of cancer mortality worldwide1. Colorectal cancers account for over nine percent of newly diagnosed cancers, with around 1.2 million new cases and 600,000 associated deaths worldwide, responsible for almost 10% of all cancer deaths1. But colorectal carcinoma is unequal in geographic distribution. It is mainly a disease of developed countries with a western culture with a comparatively lower incidence in Asian and African countries including India however recent studies have shown an increase in incidence in these regions. It is an important public health problem with many proven screening tests and a higher chance of long disease free survival or cure when identified and treated in its early stages. Unfortunately most patients present at an advanced stage due to its clinical nature. AIMS AND OBJECTIVES: To study the expression of Survivin in colorectal neoplasia, its role in adenomacarcinoma sequence and to correlate the expression of Survivin with clinicopathological parameters of the tumor including age, gender, adenocarcinoma grade, Ki-67 labelling index and stage. MATERIALS AND METHODS: 30 cases of normal colonic mucosa, 30 cases of colorectal adenomas and 30 cases of colorectal adenocarcinomas were immunohistochemically analysed for the expression of Survivin and Ki-67. Mean percentage of cells positive for the expression of Survivin and Ki-67 was determined in at least 5 areas at 400-fold magnification. RESULTS: Normal mucosa had negligible Survivin expression. The percentage of cells expressing Survivin increased in the transition from normal mucosa to adenoma to adenocarcinoma and it was statistically significant and had a significant correlation with Ki-67 labelling index. Survivin expression was significantly higher in poorly differentiated adenocarcinomas compared to well and moderately differentiated adenocarcinomas. There was also a significant correlation between Survivin expression and AJCC stage of adenocarcinoma. There was no correlation between Survivin expression and age and gender. CONCLUSION: The expression of Survivin plays an important role in the adenoma-carcinoma sequence and has a significant positive correlation with the grade, Ki-67 labelling index and AJCC stage of colorectal adenocarcinomas. However no correlation was found with age and gender. Survivin could prove to be an useful new biomarker for aggressiveness and prognostic information in colorectal adenocarcinomas.

Item Type: Thesis (Masters)
Additional Information: Reg.No.201413051
Uncontrolled Keywords: Survivin, Inhibitor of apoptosis, colorectal adenomas, colorectal adenocarcinomas, Ki-67, adenoma-carcinoma sequence, immunohistochemistry.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 18 Jul 2020 16:29
Last Modified: 18 Jul 2020 16:29

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