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AIM: To study the role of survivin expression induced by chemotherapy agent (doxorubicin) in the development and anti-chemotherapy of cholangiocarcinoma.METHODS: Expression of survivin was detected by SP immunohistochemical technique in 33 cases of cholangiocareinoma, 28 cases of adjacent noncancerous bile duct, and 5 cases of benign bile duct lesions. Low concentration of doxorubicin (0.05 mg/l) was added in cultured cholangiocarcinoma cell line (QBC939). The expression of survivin was detected by RT-PCR and West blot at 24 h and 48 h after adding doxorubicin.RESULTS: Survivin was expressed in 24 of 33 cholangiocarcinoma cases (72.7%). In contrast, no expression of survivin in adjacent noncancerous and benign bile duct lesions was observed (P＜0.01). No correlation was found between survivin expression and clinical features. Doxorubicin could markedly (p＜0.001) up-regulate survivin mRNA and protein expression of QBC939 cells.CONCLUSION: Overexpression of survivin in cholangiocarcinomas may play an important role in the development of cholangiocarcinoma, its relationship with prognosis of cholangiocarcinoma deserves further investigation. Higher expression of survivin is induced by doxorubicin in QBC939.Survivin expression may resist apoptosis induced by chemotherapy agents.