Combination of p53AIP1 and survivin expression is a powerful prognostic marker in non-small cell lung cancer

Background: p53AIP1 is a potential mediator of apoptosis depending on p53, which is mutated in many kinds of carcinoma. High survivin expression in non-small cell lung cancer is related with poor prognosis. To investigate the role of these genes in non-small cell lung cancer, we compared the relationship between p53AIP1 or survivin gene expression and the clinicopathological status of lung cancer. Materials and methods: Forty-seven samples from non-small cell lung cancer patients were obtained between 1997 and 2003. For quantitative evaluation of RNA expression by PCR, we used Taqman PCR methods. Results: Although no correlation between p53AIP1 or survivin gene expression and clinicopathological factors was found, the relationship between survivin gene expression and nodal status was significant (p=0.03). Overall survival in the p53AIP1-negative group was significantly worse than in the positive group (p=0.04); however, although survivin expression was not a prognostic factor, the combination of p53AIP1 and survivin was a significant prognostic predictor (p=0.04). In the multivariate cox proportional hazard model, the combination was an independent predictor of overall survival ( p53AIP1 (+) survivin (+), HR 0.21, 95% CI = [0.01-1.66]; p53AIP1 (+) survivin (-), HR 0.01, 95% CI = [0.002-0.28]; p53AIP1 (-) survivin (-), HR 0.01, 95% CI = [0.002-3.1], against p53AIP1 (-) survivin (+), p = 0.03). Conclusion: These data suggest that the combination of p53AIP1 and survivin gene expression may be a powerful tool to stratify subgroups with better or worse prognosis from the variable non-small cell lung cancer population.