Cellular Oncology

, Volume 41, Issue 2, pp 141–157 | Cite as

p53 expression and subcellular survivin localization improve the diagnosis and prognosis of patients with diffuse astrocytic tumors

  • Roberta Soares Faccion
  • Paula Sabbo Bernardo
  • Giselle Pinto Faria de Lopes
  • Leonardo Soares Bastos
  • Cristina Lordello Teixeira
  • José Antonio de Oliveira
  • Priscila Valverde Fernandes
  • Luiz Gustavo Dubois
  • Leila Chimelli
  • Raquel Ciuvalschi Maia
Original Paper



Diffuse astrocytic tumors are the most frequently occurring primary central nervous system (CNS) tumors. Their histological sub-classification into diffuse astrocytoma (DA), anaplastic astrocytoma (AA) and glioblastoma (GB) is challenging and the available prognostic factors are limited to age and tumor subtype. Biomarkers that may improve the histological sub-classification and/or serve as prognostic factors are, therefore, urgently needed. The relationship between survivin and p53 in diffuse astrocytic tumor progression and survival is currently unclear. Here, we aimed to assess the relevance of these proteins in the accuracy of the histological sub-classification of these tumors and their respective treatment responses.


One hundred and thirty-three formalin-fixed paraffin-embedded diffuse astrocytic tumor samples were included. The tumor samples were histologically reviewed and subsequently assessed for p53 and survivin expression and the presence of the IDH R132H mutation by immunohistochemistry. p53 expression levels and survivin subcellular localization patterns were correlated with histological classification and clinical outcome.


We found that age and histological subtype were the only features with a prognostic impact. In addition, we found that high p53 expression levels and a nuclear survivin localization correlated with the AA subtype, whereas cytoplasmic survivin localization correlated with the GB subtype. We also found that patients carrying tumors with a high cytoplasmic survivin expression, a high nuclear survivin expression or a high p53 expression, and who did not receive radiotherapy, exhibited poorer short-term and long-term overall survival rates.


Our data suggest that subcellular survivin localization and p53 expression may be employed as valuable tools to improve the accuracy of the histological sub-classification of diffuse astrocytic tumors. Patients whose tumors overexpress these proteins may benefit from radiotherapy, irrespective age and/or histological classification.


Astrocytic tumors Survivin p53 Subcellular localization Diagnosis Prognosis 



This work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação para Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ), Instituto Nacional de Ciência e Tecnologia (INCT) para Controle do Câncer and the Programa de Oncobiologia (Fundação do Câncer and UFRJ). PSB was first supported by a PhD scholarship from FAPERJ and then by a post-doctoral fellowship from the Ministério da Saúde/Instituto Nacional de Câncer. RSF was first supported by a PhD scholarship from CNPq and then by a post-doctoral fellowship from the Ministério da Saúde/Instituto Nacional de Câncer. We would like to thank all patients enrolled in the study and the physicians from the Neurosurgery Service for their participation. We also acknowledge Dr. Mauricio G S Costa from Instituto Oswaldo Cruz (FIOCRUZ) for his help with the artwork.

This work was funded by the Instituto Nacional de Ciência e Tecnologia para o Controle do Câncer [Award number: INCT-573806/2008-0 (FAPERJ-E29/110.278/2010, CNPq-306141/2010-8)], the Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (Award number: E-26/103.140/2011) and the Programa de Oncobiologia (Award number: Programa de Oncobiologia/2016 UFRJ/FAF).

Compliance with ethical standards

Conflict of interest

The authors declare to have no conflict of interest.

Research involving human participants and/or animals

The authors declare that our Institutional Ethics Committee approved this study (under the registries 46/04 and 114/08), which was conducted in agreement with the recommendations of the Helsinki Declaration. For retrospective studies informed consent is not required.

Supplementary material

13402_2017_361_MOESM1_ESM.docx (20 kb)
ESM 1 (DOCX 19 kb)


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Copyright information

© International Society for Cellular Oncology 2018

Authors and Affiliations

  • Roberta Soares Faccion
    • 1
    • 2
  • Paula Sabbo Bernardo
    • 1
    • 3
  • Giselle Pinto Faria de Lopes
    • 1
  • Leonardo Soares Bastos
    • 4
  • Cristina Lordello Teixeira
    • 5
  • José Antonio de Oliveira
    • 6
  • Priscila Valverde Fernandes
    • 7
  • Luiz Gustavo Dubois
    • 8
  • Leila Chimelli
    • 9
  • Raquel Ciuvalschi Maia
    • 1
  1. 1.Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia MolecularHospital do Câncer I, Centro de Pesquisas do Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)Rio de JaneiroBrazil
  2. 2.Programa de Pós-Graduação em Ciências Biológicas – Fisiologia, Instituto de Biofísica Carlos Chagas Filho, Centro de Ciências da SaúdeUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
  3. 3.Programa de Pós-Graduação Stricto Sensu em Oncologia, INCARio de JaneiroBrazil
  4. 4.Programa de Computação Científica (PROCC), Presidência, Fundação Oswaldo Cruz (Fiocruz)Rio de JaneiroBrazil
  5. 5.Serviço de Patologia Clínica, Hospital do Câncer I, INCARio de JaneiroBrazil
  6. 6.Serviço de Neurocirurgia, INCARio de JaneiroBrazil
  7. 7.Divisão de Patologia, INCARio de JaneiroBrazil
  8. 8.Laboratório de Biomedicina do CérebroInstituto Estadual do Cérebro Paulo Niemeyer (IECPN)Rio de JaneiroBrazil
  9. 9.Laboratório de Neuropatologia e Genética MolecularInstituto Estadual do Cérebro Paulo Niemeyer (IECPN)Rio de JaneiroBrazil

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