Survivin: A novel neuroendocrine marker for pheochromocytoma

Christian A. Koch, Alexander O. Vortmeyer, Raihanatou Diallo, Christopher Poremba, Thomas J. Giordano, Donita Sanders, Stefan R. Bornstein, George P. Chrousos, Karel Pacak

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Objective: To study survivin expression in human adrenal medulla and in benign and malignant pheochromocytoma tissue as a tool to predict tumor metastatic potential and prognosis. Design: Blinded study to assess the role of the anti-survivin antibody in chromaffin cells. Methods: We performed immunohistochemistry with a purified rabbit-polyclonal anti-survivin anti-body on 39 formalin-fixed and paraffin-embedded pheochromocytoma/paraganglioma specimens, and on 10 normal adrenal medulla samples from patients unaffected by a chromaffin cell tumor. Fourteen samples were from 14 patients with benign pheochromocytoma (<8 year follow-up, mean 5.2 years), 18 specimens were from 12 patients with malignant pheochromocytoma (<13 year follow-up, mean 6.3 years), 5 samples were from 2 patients with malignant paraganglioma (<6 year follow-up, mean 4 years), and 2 specimens from 2 patients with benign paraganglioma (<7 year follow-up, mean 5.5 years). Malignancy was defined by metastases in non-chromaffin tissues. Staining intensity with the anti-survivin antibody was scored from 0 (none) to 3+ (heavy). Tissues from human kidney, breast, and melanoma served as controls. Results: All pheochromocytoma/paraganglioma specimens stained either 2+ or 3+. By analysis of variance (ANOVA), there was no statistically significant difference between the staining intensity of benign and malignant samples. All normal adrenal medulla specimens stained positively with anti-survivin but to a lesser degree than the chromaffin cell tumors (P < 0.01). Conclusions: Based on these findings, we conclude that (i) survivin may represent a novel neuroendocrine marker for chromaffin cell tumors, and (ii) survivin does not appear to reliably distinguish benign from malignant pheochromocytomas/paragangliomas and thus does not identify patients at risk of recurrent disease.

Original languageEnglish (US)
Pages (from-to)381-388
Number of pages8
JournalEuropean Journal of Endocrinology
Issue number3
StatePublished - 2002

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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