Anti-apoptosis gene, survivin, and prognosis of neuroblastoma

Neuroblastoma may be aggressive with a dismal outcome or regress spontaneously. Prognostic factors including age, stage, and ploidy, N-myc amplification, and histology are necessary to direct treatment. Gene products controlling apoptosis may modulate neuroblastoma's variable course. 1 Pritchard J Hickman JA Why does stage 4s neuroblastoma regress spontaneously?. Lancet. 1994; 344: 869-870 Abstract PubMed Scopus (104) Google Scholar Although expression of anti-apoptotic bcl-2 has been linked to a more aggressive disease, 2 Castle VP Heidelberger KP Bromberg J Ou X Dole M Nunez G Expression of the apoptosis-suppressing protein bcl-2, in neuroblastoma is associated with unfavourable histology and N-myc amplification. Am J Pathol. 1993; 143: 1543-1550 PubMed Google Scholar and inversely correlated with morphological features of apoptosis, it is unclear whether inhibition or apoptosis is a predictive factor in neuroblastoma or whether it reflects the degree of cell differentiation. 3 Hoehner JC Hedborg F Wiklund HJ Olsen L Pahlman S Cellular death in neuroblastoma: In situ correlation of apoptosis and bcl-2 expression. Int J Cancer. 1995; 62: 19-24 Crossref PubMed Scopus (59) Google Scholar An apoptosis inhibitor, survivin, 4 Ambrosini G Adida C Altieri DC A novel anti-apoptosis gene, survivin, expressed in cancer and lymphoma. Nat Med. 1997; 3: 917-921 Crossref PubMed Scopus (3000) Google Scholar has recently been identified. Unlike other members of the bcl-2 and IAP gene families, survivin is selectively expressed in all the most common human cancers but not in normal adult tissues. 4 Ambrosini G Adida C Altieri DC A novel anti-apoptosis gene, survivin, expressed in cancer and lymphoma. Nat Med. 1997; 3: 917-921 Crossref PubMed Scopus (3000) Google Scholar We determined the expression of survivin in neuroblastoma and its relation to disease progression.