The survivin protein contributes to the development and progression of tumors. Protein
expression and mRNA levels correlate with clinicopathological parameters and survival
of cancer patients. Our purpose was to evaluate whether circulating survivin levels
have any diagnostic or predictive value in lung cancer. 118 patients with advanced
stage lung cancer participated in our study. 53 suffered from adenocarcinoma (ADC),
33 from squamous cell carcinoma (SqCC), and 32 from small cell lung cancer (SCLC).
We also enrolled 21 control subjects. Blood samples were collected before and after
two cycles of chemotherapy. We measured survivin concentrations with ELISA. Non-parametric
tests were used for analysis. We did not find significant difference in survivin levels
between patients and control subjects (17.19/0-829.74/vs. 49.13/0-165.92/pg/ml; p
= 0.07). We found lower survivin concentrations in patients with SqCC (0/0-171.24/pg/ml)
than in those with ADC (24.94/0-626.46 pg/ml) and SCLC (45.51/0-829.74/pg/ml) (ADC
vs. SqCC p < 0.0001, ADC vs. SCLC p = 0.0405, SqCC vs. SCLC p < 0.0001). Survivin
levels were higher in stage IV patients than in patients without distant metastases
(p = 0.0061), and concentrations were progressively higher with increasing number
of metastatic organ sites (p = 0.04). We observed a decrease in survivin levels in
ADC patients after platinum plus pemetrexed chemotherapy (26.22/0-626.46/pg/ml before
vs. 0/0-114.36/pg/ml after; p = 0.01). Neither progression-free nor overall survival
correlated with survivin levels at baseline. Our data imply that survivin may be involved
in the development of metastases and it might be used as a biomarker of disease progression.
However, circulating survivin concentrations do not predict survival of patients with
lung cancer.
