Circulating and Local Nuclear Expression of Survivin and Fibulin-3 Genes in Discriminating Benign From Malignant Respiratory Diseases: Correlation Analysis
Abstract Background: Survivin is a common member of the inhibitors of the apoptosis protein (IAP) family and promoter of cell proliferation. Fibulin-3 is a matrix glycoprotein with a potential for tumor suppression or propagation. The aim of this study was to validate the expression levels of survivin and fibulin-3 in benign and malignant respiratory diseases.Methods: This case-control study included 219 patients categorized into 5 groups. Group A included 63 patients with lung cancer, group B included 63 patients with various benign lung diseases, group D included 45 patients with malignant pleural mesothelioma (MPM) and group E included 48 patients with various benign pleural diseases. Group C included 60 healthy individuals (control group). Serum survivin and fibulin-3 levels were measured using ELISA assay kits, while their nuclear expression in the lung and pleura was assessed using western blot analysis. Data entry and data analysis are done using SPSS version 19. The Medcalc Program was used to calculate sensitivity, specificity and positive and negative predictive values with calculation of the AUC (95% CI). Results: The overall results showed significantly higher survivin serum levels with significantly lower fibulin-3 levels among group A when compared with both patients in group B and the controls (p<0.001 for all). There were statistically significant higher serum levels of survivin and fibulin-3 among group D when compared with both patients in group E and the controls (p<0.001 for all). These findings were consistent with nuclear survivin and fibulin-3 expression levels. Fibulin-3 was more valid than survivin in discriminating lung cancer from MPM (p˂0.05). Conclusions: Survivin and fibulin-3 could be helpful diagnostic markers for lung and pleural cancers. Fibulin-3 was more specific in differentiating lung cancer from MPM.Trial registration: ClinicalTrials.gov Identifier: NCT04413292: https://clinicaltrials.gov/ct2/show/NCT04413292, retrospectively registered.