Immunohistochemical Expression of Survivin in Colorectal Adenomas and Its Correlation With Grade of Dysplasia - a Cross Sectional Study in a Tertiary Care Centre in South Kerala

Background Colorectal cancer commonly develops through the adenoma–carcinoma sequence. Survivin, a member of the inhibitor of apoptosis protein family, regulates apoptosis and cell proliferation and is minimally expressed in normal adult tissues. Its re-expression in colorectal neoplasia suggests a role in early tumorigenesis and progression. Objectives To evaluate the immunohistochemical expression of Survivin in colorectal adenomas and to assess its association with the grade of dysplasia. Materials and Methods This cross-sectional study included 40 cases of colorectal adenomas selected by consecutive sampling after ethical clearance. Clinicopathological details were recorded. Histomorphological assessment was performed, followed by immunohistochemical evaluation of Survivin expression. The expression pattern was analysed and correlated with the grade of dysplasia. Results Survivin expression was detected in a significant proportion of colorectal adenomas. A statistically significant increase in Survivin expression was observed with increasing grades of dysplasia, with higher expression noted in high-grade dysplasia compared to low-grade dysplasia. Conclusion Survivin expression shows a significant association with increasing grades of dysplasia in colorectal adenomas, supporting its role in early colorectal tumorigenesis. Immunohistochemical assessment of Survivin may help identify adenomas with higher malignant potential.