Abstract
ObjectiveOverexpression of survivin has been reported in many human tumors. However, the clinicopathological features associated with survivin overexpression in cervical carcinoma remain controversial. Thus, the current meta-analysis was performed to assess the clinicopathological significance of survivin in cervical carcinoma.MethodsPubMed, EMBASE, and Web of Science databases were searched for relevant studies published through November 1, 2015. A meta-analysis was performed to evaluate the association between survivin expression and clinicopathological outcome in cervical carcinoma.ResultsEleven eligible studies with a total of 865 patients were included. Survivin overexpression was closely related to lymph node metastasis (odds ratio [OR] = 0.679, 95% confidence interval [CI]: 0.509–0.905, P = 0.008) but was not significantly associated with tumor FIGO stage (I+II vs. III+IV) (OR = 0.843, 95% CI: 0.626–1.137, P = 0.264), tumor grade (G1+G2 vs. G3) (OR = 0.913, 95% CI: 0.689–1.210, P = 0.527), tumor size (>4 vs. ≤4 cm) (OR = 0.825, 95% CI: 0.434–1.570, P = 0.559), or stromal involvement (OR = 0.820, 95% CI: 0.545–1.233, P = 0.340). The correlation between survivin expression and overall survival was evaluated among a total of 238 patients from three eligible studies. The pooled HR was 1.129 (95% CI: 0.597–1.661; P = 0.000), indicating that survivin expression was significantly associated with poor survival in cervical carcinoma.ConclusionsBased on the current meta-analysis, survivin is strongly associated with lymph node metastasis and poor prognosis. Additionally, survivin is a novel clinicopathological marker of cervical carcinoma and thus may be a therapeutic target for cervical carcinoma.
Highlights
Cervical carcinoma is the main lethal malignancy affecting the female reproductive system
The pooled HR was 1.129, indicating that survivin expression was significantly associated with poor survival in cervical carcinoma
Based on the current meta-analysis, survivin is strongly associated with lymph node metastasis and poor prognosis
Summary
Cervical carcinoma is the main lethal malignancy affecting the female reproductive system. Therapeutic options have improved, the treatment of lymph node metastasis and locally advanced tumors remains a major challenge [2]. Recurrent disease develops in more than 70% of patients with lymph node metastasis but only approximately 10–20% of patients without advanced cervical carcinoma [3]. Identifying clinicopathological markers to predict lymph node metastasis and the development of malignant tumors may reveal potential therapeutic targets for cervical carcinoma. Survivin is expressed in many malignant tumors, including those affecting lung, liver, breast and the gastrointestinal system [4,5,6,7], but is undetectable in nonproliferating adult tissues [8]. Survivin is considered a novel clinicopathological marker for numerous human malignant tumors. Survivin inhibits apoptosis, enhances proliferation, and promotes angiogenesis [9,11,12]
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