ORIGINAL RESEARCH Expression Analysis of Survivin and XIAP in Gallbladder Cancer: a Case-control Study in Indo-Gangetic Plain Ruhi Dixit 1 & Mohd Raza 1 & Mohan Kumar 2 & S. Basu 1 & V. K. Shukla 1 # Springer Science+Business Media, LLC 2017 Abstract Purpose Gallbladder cancer is a highly mortal disease with poor prognosis because of late presentation of disease. Survivin and X-linked inhibitor of apoptosis (XIAP) are one of the two important members of inhibitors of apoptosis. Thus, this study aimed to look at the expression of Survivin and XIAP in gallbladder cancer patients. Methods Survivin and XIAP expression were investigated in tissues of gallbladder cancer patients (40 cases) and compared with cholelithiasis as control (40 cases) by using immunohis- tochemistry. Their expression was correlated with clinicopath- ological parameters. Results Significantly higher (p < 0.05), Survivin protein was expressed in gallbladder cancer (n = 67.5%) than control (n = 35%). But it did not show any significant association with any of the clinicopathological parameter while XIAP was not expressed in the GBC patients (p > 0.05). Conclusion Overexpression of Survivin in gallbladder cancer suggests its possible role and association with poor prognosis. But XIAP has not been found to be associated with gallblad- der carcinogenesis. Keywords Gallbladder cancer . Immunohistochemistry . Inhibitors of apoptosis . Survivin . XIAP Introduction Gallbladder cancer (GBC) is an aggressive and highly lethal malignancy [1], the most common cancer of the biliary tract and the sixth most common gastrointestinal cancer [2]. GBC has astonishing symptomatology which results in advanced disease at the time presentation lead to the poor prognosis [3]. Gallbladder carcinogenesis is a multi-step process which results from sequential genetic alterations at different stages of evolution. Development of biomarkers for early detection of GBC is a need of the day [4]. Inhibition of apoptosis is a main factor in the uncontrolled proliferation of cancer cells and is closely related to the tumorigenesis and progression of malig- nant tumors [5]. Many studies have shown that inhibition of apoptosis plays an important role in tumor growth and drug resistance [6]. Inhibitor of apoptosis (IAP) is identified as a family of endogenous inhibitors of caspases [7, 8]. X-linked IAP (XIAP) and Survivin is the most potent member of human IAPs [9]. XIAP directly binds to caspase- 3, -7, -9, and prevents their activities to initiate or execute apoptotic pathways [10]. XIAP has been shown to be overexpressed in most human cancer cell lines and cancer tissues including hepatocellular carcinoma tissues [11]. Irregular expression of XIAP is described in the pathology of several human malignancies. However, only a few large- scale studies provide translational evidence of an association between XIAP expression and clinical outcomes [12–16]. Survivin is an intracellular, multifunctional protein which controls cell proliferation, inhibition of apoptosis, and the pro- motion of angiogenesis [17, 18]. Survivin overexpression has been studied in various cancers like breast, esophagus, pan- creas, bladder, uterus, cervix, ovary, large-cell non-Hodgkin’ s lymphoma, and leukemia, neuroblastomas, melanomas, gas- tric tumors, colon, stomach, liver, oral, thyroid, laryngeal, os- teosarcoma, and prostate cancer [18, 19]. Increased Survivin * V. K. Shukla vkshuklabhu@gmail.com 1 Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India 2 Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India J Gastrointest Canc DOI 10.1007/s12029-017-0008-9