Abstract: Objective: To study the expression of Survivin in Dukes'C stage colorectal cancer tissue and the value of predicting response to adjuvant chemotherapy. Methods: The expression of Survivin was detected immunohistochemically in 14 cases of normal colorectal tissues, and 85 paraffin-embedded tumor samples from patients with Dukes'C stage colorectal carcinomas after curative resection and standard adjuvant chemotherapy. The relationship with clinical characteristics and survival analysis were statistically analyzed. Results: A 51.76 of tumors were Survivin-positive. In contrast, normal tissues did not express Survivin (P<0.05). Survivin expression did not correlate with age, gender, course of disease, tumor location, tumor gross type, tumor size, histological type, histological grade, infiltration degree, and lymph node metastasis site(P>0.05). Survivin-positive cases were strongly associated with recurrence and metastasis. The frequency of recurrence and metastasis in positive cases was much higher than that in negative cases. When analysed for prognostic significance, 3-year and 5-year disease-free survival rates and overall survival rates were lower in the Survivin-positive patients than the group with Survivin-negative expression. Cox proportional hazards model analysis showed that Survivin was an inindepentant factor for tumor recurrence and metastasis and overall survival. Conclusion: Over-expression of Survivin in Dukes'C stage colorectal cancer is related with response to adjuvant chemotherapy. It may be a potential molecular index to predict adjuvant chemotherapy sensitivity.