Apoptosis Inhibitor, Survivin, in Posterior Uveal Melanoma: Comparison Among Primary Tumors, Tumors Resistant to Brachytherapy, Tumors with Liver Metastases, and Liver Metastases

Abstract

Purpose: To study the expression of survivin, an apoptosis inhibitor protein, in human posterior uveal melanoma. Methods: Specimens were divided according to eyes with tumors that were enucleated primarily, those resistant to brachytherapy, eyes from patients with known liver metastases, and liver metastases. Results: There was only low expression of survivin in uveal melanoma. No difference in survivin positive cell counts per high power field (PCC/HPF) were found among tumors that were enucleated primarily (n = 33), tumors with previous brachytherapy (n = 29), tumors with liver metastases (n = 12) or liver metastases (n = 18). Corresponding counts were 11.8 (±14.3), 11.8 (±16.8), 7.1 (±11.2), and 4.7 (±8.8) in the four groups, respectively (p > 0.05). Half of the liver metastases showed no staining for survivin. Twenty patients (24%) had tumor-related death at the end of follow-up. Conclusions: Survivin is expressed in posterior uveal melanomas that were treated by enucleation, as well as in tumors that were previously treated with brachytherapy or liver metastases; however, its expression by immunostaining did not seem with correlate with the tumor biological activity.

KEYWORDS:

• brachytherapy
• inhibitors of apoptosis
• liver metastases
• survivin
• uveal melanoma