Biological implications of survivin gene expression in the development of endometriosis and endometrial carcinoma

A total of 63 pigmented or non-pigmented endometriotic, 26 endometrial carcinoma, and 12 normal eutopic endometrial tissues were examined for mRNA expression of survivin, matrix metalloproteinase (MMP)-2, MMP-9, and membrane-type 1 (MT1)-MMP. The expression levels of the survivin and MMPs genes in clinically aggressive pigmented lesions were significantly higher than those in normal eutopic endometrium, and survivin gene expression in pigmented lesions was also higher than that in non-pigmented lesions (P < 0.05). There was a close correlation between the expression levels of the survivin and MMPs genes in 63 endometriotic tissues examined (P < 0.01). Apoptotic cells detected by dUTP nick-end labeling were rare in I I ovarian endometriotic tissues, which showed positive immunohistochemical expression for survivin and MMPs. Expression levels of the survivin and MMPs genes in endometrial carcinomas were higher than those in normal eutopic endometrium and were well correlated with the depth of myometrial invasion (P < 0.05). There was a close correlation between the expression levels of the survivin and MMPs genes in 26 endometrial carcinoma tissues examined (P < 0.01). These findings suggest that upregulation of survivin and MMPs may contribute cooperatively to survival and invasion of endometriosis and endometrial carcinomas.