Role of Survivin Gene Promoter Polymorphism (−31G>C) in Susceptibility and Survival of Esophageal Cancer in Northern India

• Published in: Annals of surgical oncology Vol. 18; no. 3; pp. 880 - 887
• Main Authors: Upadhyay, Rohit, Khurana, Rohini, Kumar, Shaleen, Ghoshal, Uday Chand, Mittal, Balraj
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.03.2011; Springer Nature B.V
• Subjects: Carcinoma, Squamous Cell - genetics; Carcinoma, Squamous Cell - secondary; Case-Control Studies; Esophageal Neoplasms - genetics; Esophageal Neoplasms - pathology; Female; Humans; Inhibitor of Apoptosis Proteins - genetics; Lymphatic Metastasis; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Polymerase Chain Reaction; Polymorphism, Genetic - genetics; Polymorphism, Restriction Fragment Length; Prognosis; Promoter Regions, Genetic - genetics; Risk Factors; Surgery; Surgical Oncology; Survival Rate; Translational Research and Biomarkers; Esophageal Cancer; Esophageal Cancer Patient; Environmental Risk Factor; Recessive Model; Esophageal Squamous Cell Carcinoma
• DOI: 10.1245/s10434-010-1371-y
• ISSN: 1068-9265; 1534-4681

Background and Aim Survivin is an upregulated inhibitor of apoptosis protein in esophageal cancer (EC), and a promoter region polymorphism (−31G>C) in the survivin gene has been reported as a modulator of gene expression. We aim to explore the role of survivin −31G>C polymorphism in susceptibility and survival of EC patients in northern Indian population. Materials and Methods A case–control study was performed in 500 subjects (250 EC patients and 250 controls), and genotyping was done by polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) method. Results Survivin CC genotype was found to be significantly associated with EC susceptibility [odds ratio (OR) = 2.29; 95% confidence interval (CI) = 1.27–4.14; P  = 0.006], particularly in males (OR = 4.91; 95% CI = 2.19–11.02; P  = 0.0001) having squamous cell carcinoma (SCC) histopathology (OR = 2.4; 95% CI = 1.36–4.21; P  = 0.002) at middle third esophagus location (OR = 2.60; 95% CI = 1.40–4.82; P  = 0.002). Patients carrying CC genotype were found to have higher susceptibility to lymph node metastasis (OR = 2.82; 95% CI = 1.46–5.48; P  = 0.002). However, on survival analysis, no prognostic role of survivin −31G>C polymorphism was detected. In case-only analysis, no gene–environment interaction was observed. Conclusion Survivin promoter region polymorphism (−31G>C) is associated with susceptibility and clinical characteristics but not prognosis of esophageal cancer in northern Indian population.