الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Colorectal cancer is the second leading cause of cancer related mortality in Western Countries. Adenocarcinoma constitute the vast majority of colorectal cancers and represent 70% of all malignancies arising in the gastrointestinal tract
Survivin, a novel member of IAP family, directly inhibits caspase-3 and -7 activity or conjugates caspase-9 (the caspase-cascade system plays vital roles in the induction, transduction and amplification of intracellular apoptotic signals) and also it regulates the cell cycle in the G2/M phase by interact with spindle microtubules. It is present during embryonic and fetal development, but is down-regulated in normal adult tissues. However, it becomes re-expressed in a variety of cancers.
The present work aimed to determine the expression of survivin in colorectal carcinoma and to correlate the expression of survivin in colorectal carcinoma with other established prognostic parameters of colorectal carcinoma (tumor shape, tumor site, lymph node metastasis, tumor grade and Duke’s stage).
The present work was undertaken on fifty cases of colorectal carcinoma and ten cases of normal colonic tissue; Cases were collected between January 2010 and April 2011 (they included 34 male and 26 female) from the Pathology Department, Medical Research Institute, Alexandria University.
According to the results of the present study the normal colonic tissue showed no survivin staining either in the nucleus or the cytoplasm. On the other hand mainly cytoplasmic survivin staining was identified in the tumor cells with few cases expressing both cytoplasmic and nuclear survivin.
The statistical analysis was performed on forty six cases of colonic adenocarcinoma (46) and four cases of mucinous carcinoma (4).
In the present study, correlation was done between survivin positivity and the clinicopathological variables. There was no statistically significant difference between the survivin positive and survivin negative cases as regards age (P=1.000), gender (P=0.919) and tumor size (P=0.721).
There was statistically significant difference between survivin positive and survivin negative groups regarding the site (P=0.011), shape (P=0.035), grade (P=0.035), L.N involvement (P=0.005) and stage (P=0.003); Survivin positivity is towards left sided tumors, infiltrating growth pattern, lower degree of histological differentiation, L.N metastasis and higher stage.
Therefore from our study we conclude that, survivin expression is linked with an aggressive phenotype in colorectal carcinoma and is related to poor prognosis.