Association between high survivin expression and late clinical stage of nasopharyngeal non-keratinizing squamous cell carcinoma

Introduction: Nasopharyngeal carcinoma is one of the most common head and neck malignancy in Indonesia. Due to the evaluation of clinical stage is not enough to predict its prognosis, therefore other markers are needed to help to assess its progressivity. One of the markers is known as survivin, an apoptosis inhibitor, which usually shows increase expression in carcinoma. Roles of survivin in nasopharyngeal carcinoma carcinogenesis has not been studied well yet. The aim of this study was to analyze the association between high survivin expression and the late clinical stage of nasopharyngeal non-keratinizing squamous cell carcinoma. Methods: This study was a cross-sectional observational analytic study, involved 30 histopathological samples of nasopharyngeal non-keratinizing squamous cell carcinoma, which have been examined at Pathology Anatomy Laboratory Sanglah Hospital by using stratified random sampling from January 2nd, 2014 to May 31st, 2017. The paraffin slides were stained with survivin immunohistochemical at Pathology Anatomy Laboratory Dr. Sardjito Hospital Yogyakarta. The cut-off point of survivin expression was analyzed by Receiver Operator Curve (ROC) analysis. The association between survivin expression and the clinical stage was analyzed with Fisher’s Exact test. Results: The cut-off point of survivin expression based on ROC analysis was 4.5. High survivin expression was significantly associated with late clinical stage cases (p=0.026; p<0.05). Conclusion: High survivin expression has a significant association with the late clinical stage of nasopharyngeal non-keratinizing squamous cell carcinoma. Survivin can be used as a prognostic marker, which is useful for nasopharyngeal carcinoma therapy.