OBJECTIVETo assess the protein expression of a new inhibitor of apoptosis, survivin, and its correlation with spontaneous apoptosis, tumor clinicopathological parameters and prognosis in nasal and paranasal sinus carcinoma (NPSC).

METHODSForty-eight patients with NPSC treated by radical operations from 1991 to 2000 were studied retrospectively. Patients included 23 females and 25 males ranging in age from 20 to 71 years. Spontaneous apoptotic cells were visualized by TUNEL accompanied by HE and PI stain. Immunohistochemistry using SP method was used to assess the expression of survivin.

RESULTSTwenty-five patients (52.08%) survived without recurrence. Recurrence or metastasis occurred in 3 patients (6.25%). Fourteen (29.17%) died from NPSC. Survivin expression was positive in 23 samples (23/48, 47.92%) but no staining was present in normal tissues beside the tumors. The expression of survivin correlated negatively with the index of apoptosis (r = - 0.393, P = 0.006). Patients with positive expression of survivin had lower apoptosis index than those with negative expression (P < 0.05). The expression of survivin in advanced stage tumors (T3 + T4) was higher than early ones (T1 + T2, P < 0.05). Patients with negative expression of survivin had much better prognosis than those with positive expression (P = 0.0346). Multivariate analyses revealed that expression of survivin and histological types were independent prognostic factors for overall survival.

CONCLUSIONAn inverse correlation between survivin expression and the level of spontaneous apoptosis in NPSC suggests that survivin may play an important role in the tumorgenesis of NPSC. Survivin expression may provide a novel predictive indicator for disease-free survival after surgical resection and postoperative radiochemotherapy in NPSC.