Association of Survivin in Liver Hepatocellular Carcinoma Patient Survival with an Emphasis on Race and Gender

Purpose: Liver hepatocellular carcinoma (LIHC) represents the most common type of primary liver cancer in many parts of the world. In LIHC, Survivin is associated with increased tumor aggression and a poorer prognosis. Survivin is a member of the inhibitor of apoptosis (IAP) protein family that inhibits caspases and thus plays a role in several molecular processes, including apoptosis. The objective of this study is to evaluate the association of Survivin expression with LIHC on the basis of race and gender. Methods: In silico analysis was conducted using information from UACLAN: A portal for facilitating tumor subgroup gene expression and survival analyses. UACLAN uses the data from The Cancer Genome Atlas (TCGA) and Clinical Proteomic Tumor Analysis Consortium (CPTAC). Results: Analysis showed a significant relationship between high Survivin expression and lower survival probability with Asian patients than those with tumors that expressed low/medium levels of Survivin. No significant relationship in survival probability was found when comparing Survivin expression among African Americans and Caucasians. There was also a significant relationship shown between low/medium and high Survivin expression in females and lower survival probability than in men with high and low/medium expression, respectively. Lastly, a significant relationship between expression of high levels of Survivin and lower survival probability than in men whose tumors expressed low/medium levels of Survivin was shown. Conclusion: Given the significance of Survivin's expression with survival probability in Asians and gender, Survivin is a promising prognostic biomarker and target for improving the prognosis or treatment of LIHC patients.