Correspondence re: T. Zhang et al., Evidence That APC Regulates Survivin Expression: A Possible Mechanism Contributing to the Stem Cell Origin of Colon Cancer. Cancer Res., 61: 8664–8667, 2001.

Maria Grazia Daidone; Aurora Costa; Milo Frattini; Debora Balestra; Lucio Bertario; Marco A. Pierotti

DOI: Published January 2004

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Scheme. 1.
This scheme is a diagram of the β-catenin/TCF-4/survivin pathway and its possible role in promoting colon tumorigenesis. The left side of the scheme shows the effect of APC on β-catenin when both proteins are wild type. The right side shows the consequences of homozygous mutations in APC or an activating mutation in β-catenin. These two conditions, which are depicted on the left and right side of the scheme, portray mechanisms linked to normal colonic epithelial homeostasis and enhanced colon tumorigenesis, respectively. ^aThe APC:β-Catenin protein complex also contains the proteins axin and GSK3β. ^bThe Survivin:Aurora B Kinase protein complex also contains the INCENP protein.

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Table 1

Biological features associated with proliferation and apoptosis in colon cancers characterized for dysregulation in the APC/β-catenin/T-cell factor pathway

	Total cases	Survivin expression^a		Apoptotic index^b median value (range)	Proliferation index^c median value (range)
	Total cases	Median value (range)	% of positive cases	Apoptotic index^b median value (range)	Proliferation index^c median value (range)
β-Catenin negative^d (microsatellite instability positive)	10	70 (0–100)	80%	0.6 (0–1.2)	72.5 (50–100)
β-Catenin positive (microsatellite instability negative)	61	50 (0–90)	74%	0.4 (0–18.7)	85.0 (50–100)

^a Percentage of tumor cells with cytoplasmic immunostaining. Cut-off value for positive cases = 25% of positive cells.
^b Percentage of tumor cells with cytoplasmic immunostaining for M30.
^c Percentage of tumor cells with nuclear immunostaining for MIB-1.
^d β-Catenin protein expression was evaluated on formalin-fixed, paraffin-embedded samples by immunohistochemistry (mouse monoclonal anti-β-catenin antibody; Transduction Laboratories, Lexington, KY) for the presence of nuclear, cytoplasmic, and membranous accumulation in both tumor and normal surrounding tissues.