Open Access Open Badges Research article

High Smac/DIABLO expression is associated with early local recurrence of cervical cancer

Abril Arellano-Llamas1, Francisco J Garcia2, Delia Perez3, David Cantu4, Magali Espinosa1, Jaime G De la Garza1, Vilma Maldonado1* and Jorge Melendez-Zajgla1*

Author Affiliations

1 Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Av. San Fernando # 22, Tlalpan 14080 México City, Mexico

2 Departamento de Anatomia Patologica, Instituto Nacional de Pediatria, Insurgentes Sur # 3700, Coyoacan 04530 México City, Mexico

3 Subdireccion de Patologia, Instituto Nacional de Cancerología, Av. San Fernando # 22. Tlalpan 14080 México City. Mexico

4 Subdirección de Cirugía, Instituto Nacional de Cancerología Av. San Fernando # 22. Tlalpan 14080 México City. Mexico

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BMC Cancer 2006, 6:256  doi:10.1186/1471-2407-6-256

Published: 26 October 2006



In a recent pilot report, we showed that Smac/DIABLO mRNA is expressed de novo in a subset of cervical cancer patients. We have now expanded this study and analyzed Smac/DIABLO expression in the primary lesions in 109 cervical cancer patients.


We used immunohistochemistry of formalin-fixed, paraffin-embedded tissue sections to analyze Smac/DIABLO expression in the 109 primary lesions. Seventy-eight samples corresponded to epidermoid cervical cancer and 31 to cervical adenocarcinoma. The median follow up was 46.86 months (range 10–186).


Smac/DIABLO was expressed in more adenocarcinoma samples than squamous tumours (71% vs 50%; p = 0.037). Among the pathological variables, a positive correlation was found between Smac/DIABLO immunoreactivity and microvascular density, a marker for angiogenesis (p = 0.04). Most importantly, Smac/DIABLO immunoreactivity was associated with a higher rate of local recurrence in squamous cell carcinoma (p = 0.002, log rank test). No association was found between Smac/DIABLO and survival rates.


Smac/DIABLO expression is a potential marker for local recurrence in cervical squamous cell carcinoma patients.