Objective: To study the expression of three survivin splicing variants in gastric cancer and to evaluate the significant correlation between survivin variants' expression and chemoresistance in gastric cancer.
Methods: Real time quantitative RT-PCR was used to analyze the mRNA expression of survivin variants in 39 gastric tumor specimens resected during operation. The clinical resistance to anticancer agents [CDDP, MMC, 5-Fu, docetaxel (Taxotere TXT), and GEM] was analyzed by histoculture drug-response assay (HDRA).
Results: Among the 39 tumor samples, survivin expression was detected in all tumor samples (39/39); 79.5% (31/39) of the samples demonstrated survivin-2B expression and 66.7% (26/39) of the samples had survivin-Delta Ex3 expression. HDRA showed that the in vitro efficacy rates of CDDP, MMC, 5Fu, TXT, and GEM were 36.8% (14/38), 31.2% (10/32), 23.1% (9/39), 20.5% (8/39), and 12.5% (4/32) respectively, equivalent to the previous HDRA studies and historical clinical studies in gastric cancer patients. The expression rate of wild-type survivin was significantly higher in the group of chemoresistance to TXT than in the group sensitive to docetaxel (P = 0.021).
Conclusion: Elevated expression level of wild-type survivin promotes docetaxel-resistance in patients with gastric cancer.