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Survivin Gene as a Potential Marker in Premalignant and Malignant Lesions of Oral Cavity

Lingamdenne Paul Emerson and Pallipamu Prakash Babu

In a developing country where most of the people live in rural areas, Oral cancer management is a challenge with most of the cases presenting late. Carcinogenesis is a multistage process involving the activation of oncogenes and the inactivation of tumour suppressor genes. Biomarkers are important in establishing an accurate diagnosis and also can provide prognostic data. Survivin, a member of the inhibitor of apoptosis (IAP) protein family that inhibits caspases and blocks cell death, is highly expressed in most cancers and is associated with a poor clinical outcome. Survivin has consistently been identified by molecular profiling analysis to be associated with high tumour grade cancers, disease survival and recurrence. Polymorphisms in the survivin gene are emerging as powerful tools to study the biology of the disease and have the potential to be used in disease prognosis and diagnosis. The survivin gene polymorphisms have also been reported to influence tumour aggressiveness as well as survival of cancer patients. The differential expression of survivin in cancer cells compared to normal tissues and its role as a nodal protein in a number of cellular pathways make it a high target for different therapeutics. This review focuses on the literature on survivin, its role in cancerous and pre-cancerous lesions of oral cavity. It also gives a snapshot of its use in diagnosis, management and therapeutic management.