Expression and Clinical Significance of Survivin in Cervical Cancer: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 ZHANGJing ¹ , WANGYu-juan ¹ , HUOJun-ling ¹ , ZHANGLi ¹ ,  WANGZan-hong ²

1. Shanxi Medical University, Taiyuan 030001, China;
2. Department of Gynecology, Shanxi Academy of Medical Sciences, Shanxi Da Yi Hospital, Taiyuan 030032, China;

Corresponding?author：

WANGZan-hong, Email: wangzanhong@126.com

Keywords：

Survivin; Cervical cancer; Systematic review; Meta-analysis; Case-control study

DOI：

10.7507/1672-2531.20140038

Video：

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Objective To systematically review the correlation between the expression of survivin and cervical cancer and its clinical pathologic features. Methods Systematic and comprehensive literature was searched in The Cochrane Library (Issue 1, 2013), PubMed, MEDLINE (Ovid), CNKI, CBM and WanFang Data from inception to May 2013, to retrieve case-control studies published in the foreign and domestic areas on the correlation between the expression of survivin and cervical cancer and its clinical pathologic features. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the included studies. Then meta-analysis was conducted using RevMan 5.1 software. Results A total of 13 studies involving 1 530 women (658 cervical cancer patients, 563 cervical intraepithelial neoplasis (CIN), 658 normal cervical. The results of meta-analysis showed that, a) as for the positive rate of survivin expression, significant differences were found between cervical cancer and CIN (OR=4.63, 95%CI 3.49 to 6.13, P < 0.000 01), cervical cancer and normal cervical tissues (OR=38.23, 95%CI 23.92 to 61.11, P < 0.000 01), and CIN and normal cervical tissues (OR=9.61, 95%CI 6.11 to 15.09, P < 0.000 01). b) Significant differences were found between clinical stages Ⅰ-Ⅱ and clinical stages Ⅲ-Ⅳ (OR=0.17, 95%CI 0.07 to 0.41, P < 0.000 1), cervical cancer with lymph node metastasis and that without lymph node metastasis (OR=3.57, 95%CI 2.20 to 5.78, P < 0.000 01), high and moderate/low differentiated ESCC tissues (OR=0.31, 95%CI 0.13 to 0.76, P=0.01), and shallow and deep muscular infiltration (OR=0.12, 95%CI 0.02 to 0.68, P=0.02). No significant difference was found between cervical cancer with laterouterus or haemal infiltration and that without latero-uterus or haemal infiltration (OR=24.15, 95%CI 0.07 to 8 199.76, P=0.28). Conclusion Current foreign and domestic evidence shows that, survivin expression is significantly correlated to cervical cancer and its clinically pathologic features, which may participate in the whole course of carcinogenesis of cervical cancer, but it is not considered to be an absolute factor for estimating the survival rate of patients with cervical cancer. Due to the quality limitation of the included studies, more large scale, well-designed and high quality studies are needed for further verifying the aforementioned conclusion.

Citation： ZHANGJing, WANGYu-juan, HUOJun-ling, ZHANGLi, WANGZan-hong. Expression and Clinical Significance of Survivin in Cervical Cancer: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2014, 14(2): 216-224. doi: 10.7507/1672-2531.20140038 Copy

1.	Parking DM, Bray F, Ferlay J, et al. Global cancer statistics in 2002. CA Cancer J Clin, 2005, 55(2):74-108.
2.	Elliott PM, Tattersall MH, Coppleson M, et al. Changing character of cervical cancer in young women. Br Med J, 1989, 298(2):288-290.
3.	Uchida H, Tanaka T, Sasaki K, et al. Adenovirus-mediated transfer of siRNA against survivin induced apoptosis and attenuated tumor cell growth in vitro and in vivo. Mol Ther, 2004, 10(1):162-171.
4.	顧美芳, 張美云, 莊訊.宮頸癌組織中survivin基因表達的臨床意義.南京醫科大學學報, 2008, 28(2):232-235.
5.	Wells G, Shea B, ÓConnell D, et al. Newcastle-Ottawa Quality Assessment Scale-Case Control Studies.[2012-06-15]. Available at: http://www.ohri.ca/programs/clinical-epidemiology/oxford-asp.
6.	Ambrosini G, Adida DC, Airier DC. A novel anti-apoptosis gene, survivin, expressed in cancer and lymphoma. Nat Med, 1997, 3(8):917-921.
7.	Lee JP, Chang KH, Han JH, et al. Survivin, a novel anti-apoptosis inhibitor, expression in uterine cervical cancer and relationship with prognostic factors. Int J Gynecol Cancer, 2005, 15(1):113-119.
8.	劉鳳英, 徐曉明, 劉毅智, 等.子宮頸癌組織中人乳頭狀瘤病毒16 E6 mRNA表達與survivin蛋白表達的相關性.中華婦產科雜志, 2005, 40(9):627-630.
9.	李魯宏, 張鵬飛.抑癌基因Fhit基因及凋亡抑制蛋白Survivin在宮頸鱗狀細胞癌組織中的表達及其意義.福州:福建醫科大學, 2005.
10.	褚靜萍, 王言奎. Survivin在宮頸鱗癌組織中的表達及其與p53基因表達和HPV-16感染相關性的研究.青島:青島大學, 2005.
11.	Mu YQ, Liu RH, Zhau FX. Analyses of Bcl-2, Survivin, and CD44v6 expressions and human papillomavirus infection in cervical carcinomas. Scand J Infect Dis, 2007, 39(5):441-448.
12.	張培榮, 鄭錦花, 王艷萍, 等. Survivin和PTEN蛋白在宮頸鱗狀細胞癌中的表達及臨床意義.臨床腫瘤學雜志, 2007, 12(4):271-275.
13.	馬寧, 李小姝, 張嬋麗, 等. Survivin與MIF在宮頸癌組織中的表達及意義.腫瘤基礎與臨床, 2008, 21(5):388-391.
14.	李娜, 賈金華. CyclinE、Survivin及HPV16-E6蛋白在宮頸上皮癌變過程中的表達及意義.石家莊:河北醫科大學, 2008.
15.	王秋蘭.宮頸癌中Ezrin和Survivin的表達及其與浸潤和轉移的關系.中國婦幼保健, 2010, 25(10):1405-1407.
16.	徐雅會, 王德華. Survivin與Ki67在宮頸癌中的表達及相關性研究.天津:天津醫科大學, 2010.
17.	羅靖, 左巧富, 王瑋. Survivin和p16INK4a在宮頸癌及其癌前病變中的表達及相關性.醫學臨床研究, 2010, 27(6):1031-1034.
18.	王會娟, 劉玉玲. Survivin、FHIT及bFGF在宮頸鱗癌組織中的表達及意義.鄭州:鄭州大學, 2011.
19.	Wu SF, Zhang JW, Qian WY, et al. Altered expression of survivin, Fas and FasL contributed to cervical cancer development and metastasis. Eur Rev Med Pharmacol Sci, 2012, 16(15):2044-2050.
20.	Sauber RH, Mann W, Knauer SK. Nuclear and cytoplasmic survivin:molectular mechanism, prognostic, and therapeutic potential. Cancer Res, 2007, 67(13):5999-6002.
21.	董德剛, 郭恩綿, 張瑤, 等.白藜蘆醇對宮頸癌HeLa細胞基質金屬蛋白酶及其組織抑制劑的影響.中華腫瘤防治雜志, 2007, 14(7):489-491.
22.	Lu S, Zhang B, Wang Z. Expression of survivin, cyclin d1, p21waf1, caspase-3 in cervical cancer and its relation with prognosis. J Huazhong Univ Sci Technolog Med Sci, 2005, 25(1):78-81.
23.	Lu D, Qian J, Yin X, et al. Expression of PTEN and survivin in cervical cancer promising biological markers for early diagnosis and prognostic evaluation. Br J Biomed Sci, 2012, 69(4):143-146.
24.	朗雁, 熊永炎, 陳惠楨.宮頸癌前病變和宮頸癌組織中凋亡相關基因survivin的表達及其與人乳頭狀瘤病毒感染的關系.第一軍醫大學學報, 2005, 25(10):1276-1279.
25.	李淼, 錢智, 韓曉宇.宮頸癌組織survivin與VEGF表達及其生物學意義的探討.中華腫瘤防治雜志, 2011, 18(22):1786-1788.

1. Parking DM, Bray F, Ferlay J, et al. Global cancer statistics in 2002. CA Cancer J Clin, 2005, 55(2):74-108.
2. Elliott PM, Tattersall MH, Coppleson M, et al. Changing character of cervical cancer in young women. Br Med J, 1989, 298(2):288-290.
3. Uchida H, Tanaka T, Sasaki K, et al. Adenovirus-mediated transfer of siRNA against survivin induced apoptosis and attenuated tumor cell growth in vitro and in vivo. Mol Ther, 2004, 10(1):162-171.
4. 顧美芳, 張美云, 莊訊.宮頸癌組織中survivin基因表達的臨床意義.南京醫科大學學報, 2008, 28(2):232-235.
5. Wells G, Shea B, ÓConnell D, et al. Newcastle-Ottawa Quality Assessment Scale-Case Control Studies.[2012-06-15]. Available at: http://www.ohri.ca/programs/clinical-epidemiology/oxford-asp.
6. Ambrosini G, Adida DC, Airier DC. A novel anti-apoptosis gene, survivin, expressed in cancer and lymphoma. Nat Med, 1997, 3(8):917-921.
7. Lee JP, Chang KH, Han JH, et al. Survivin, a novel anti-apoptosis inhibitor, expression in uterine cervical cancer and relationship with prognostic factors. Int J Gynecol Cancer, 2005, 15(1):113-119.
8. 劉鳳英, 徐曉明, 劉毅智, 等.子宮頸癌組織中人乳頭狀瘤病毒16 E6 mRNA表達與survivin蛋白表達的相關性.中華婦產科雜志, 2005, 40(9):627-630.
9. 李魯宏, 張鵬飛.抑癌基因Fhit基因及凋亡抑制蛋白Survivin在宮頸鱗狀細胞癌組織中的表達及其意義.福州:福建醫科大學, 2005.
10. 褚靜萍, 王言奎. Survivin在宮頸鱗癌組織中的表達及其與p53基因表達和HPV-16感染相關性的研究.青島:青島大學, 2005.
11. Mu YQ, Liu RH, Zhau FX. Analyses of Bcl-2, Survivin, and CD44v6 expressions and human papillomavirus infection in cervical carcinomas. Scand J Infect Dis, 2007, 39(5):441-448.
12. 張培榮, 鄭錦花, 王艷萍, 等. Survivin和PTEN蛋白在宮頸鱗狀細胞癌中的表達及臨床意義.臨床腫瘤學雜志, 2007, 12(4):271-275.
13. 馬寧, 李小姝, 張嬋麗, 等. Survivin與MIF在宮頸癌組織中的表達及意義.腫瘤基礎與臨床, 2008, 21(5):388-391.
14. 李娜, 賈金華. CyclinE、Survivin及HPV16-E6蛋白在宮頸上皮癌變過程中的表達及意義.石家莊:河北醫科大學, 2008.
15. 王秋蘭.宮頸癌中Ezrin和Survivin的表達及其與浸潤和轉移的關系.中國婦幼保健, 2010, 25(10):1405-1407.
16. 徐雅會, 王德華. Survivin與Ki67在宮頸癌中的表達及相關性研究.天津:天津醫科大學, 2010.
17. 羅靖, 左巧富, 王瑋. Survivin和p16INK4a在宮頸癌及其癌前病變中的表達及相關性.醫學臨床研究, 2010, 27(6):1031-1034.
18. 王會娟, 劉玉玲. Survivin、FHIT及bFGF在宮頸鱗癌組織中的表達及意義.鄭州:鄭州大學, 2011.
19. Wu SF, Zhang JW, Qian WY, et al. Altered expression of survivin, Fas and FasL contributed to cervical cancer development and metastasis. Eur Rev Med Pharmacol Sci, 2012, 16(15):2044-2050.
20. Sauber RH, Mann W, Knauer SK. Nuclear and cytoplasmic survivin:molectular mechanism, prognostic, and therapeutic potential. Cancer Res, 2007, 67(13):5999-6002.
21. 董德剛, 郭恩綿, 張瑤, 等.白藜蘆醇對宮頸癌HeLa細胞基質金屬蛋白酶及其組織抑制劑的影響.中華腫瘤防治雜志, 2007, 14(7):489-491.
22. Lu S, Zhang B, Wang Z. Expression of survivin, cyclin d1, p21waf1, caspase-3 in cervical cancer and its relation with prognosis. J Huazhong Univ Sci Technolog Med Sci, 2005, 25(1):78-81.
23. Lu D, Qian J, Yin X, et al. Expression of PTEN and survivin in cervical cancer promising biological markers for early diagnosis and prognostic evaluation. Br J Biomed Sci, 2012, 69(4):143-146.
24. 朗雁, 熊永炎, 陳惠楨.宮頸癌前病變和宮頸癌組織中凋亡相關基因survivin的表達及其與人乳頭狀瘤病毒感染的關系.第一軍醫大學學報, 2005, 25(10):1276-1279.
25. 李淼, 錢智, 韓曉宇.宮頸癌組織survivin與VEGF表達及其生物學意義的探討.中華腫瘤防治雜志, 2011, 18(22):1786-1788.

Chinese Journal of Evidence-Based Medicine

Expression and Clinical Significance of Survivin in Cervical Cancer: A Systematic Review

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