Survivin And Bcl2Protein Expression In Ovarian Endometriosis And Significance

ObjectiveTo explore the role of Survivin protein and Bcl-2protein in pathogenesisand progression of ovarian endometriosis(EMT) by detecting their expression innormal endometrium tissue and eutopic endometrial tissue and ectopicendometrial tissue of ovarian endometriosis EMT.MethodsForty-six samples of ovarian endometriosis tissue, among which30caseswere in proliferative phase and16cases in secretory phase. From above samples,30cases of eutopic endometrium including20cases in proliferative phase and10cases in secretory phase were selected. As control,30cases of normalendometrial tissue containing16cases in proliferative phase and14cases insecretory phase obtained because of uterine fibroids or curettage surgery wereused. Endometrial phase was determined according to the menstrual cycle incombination with HE staining. Expression of Survivin protein and Bcl-2proteinwere detected using immunohistochemical SP method. Statistical analysis wasdone using the fourfold table X2test and Fisher’s exact probabilistic method.Results1.Expression of Survivin(1)In normal endometrium, positive expression rate were13.33％.Survivinprotein in proliferative phase and secretory phase were0%(0/16) and28.57%(4/14) respectively. The later was higher than the former and the difference wasstatistically significant.(2)In eutopic endometrium of ovarian endometriosis, positive expressionrate were46.67%.Positive expression rate were46.67%.positive expression rateof survivin protein in proliferative phase and secretory phase were43.75%(5/16) and50%(7/14) respectively. The difference between two phases was notstatistically.(3)In ectopic endometrium of ovarian endometriosis, positive expressionrate were54.34%. Positive expression rate were54.34%.positive expressionrate of survivin protein in proliferative phase and secretory phase were46.66%(14/30) and68.75%(10/16) respectively. The difference between two phaseswas not statistically.(4)There was significant difference when comparing the rate betweennormal endometrium and ectopic endometrium or eutopic endometrium, whilethere was no significant difference between eutopic endometrium and ectopicendometrium.2.Expression of Bcl-2(1)In normal endometrium, positive expression rate were23.33%.Positiveexpression rate of Bcl-2protein in proliferative phase and secretory phase were37.5%(6/16) and0%(0/14) respectively. The former was higher than the laterand the difference was statistically significant.(2)In eutopic endometrium of ovarian endometriosis, positive expression ratewere63.33%.Positive expression rate of Bcl-2protein in proliferative phase andsecretory phase were93.75％(15/16) and28.5％(4/14) respectively. The formerwas higher than the later and the difference was statistically significant.(3)In ectopic endometrium of ovarian endometriosis, positive expression ratewere82.6%.Positive expression rate of Bcl-2protein in proliferative phase andsecretory phase were83.33％(25/30) and81.25％(13/16) respectively. Thedifference between two phases was not statistically.(4)There was significant difference when comparing the rate betweennormal endometrium and ectopic endometrium or eutopic endometrium, whilethere was no significant difference between eutopic endometrium and ectopicendometrium.Conclusions and significance1.Survivin protein may play an important role in the maintenance of normalmenstrual cycle. There was no difference of the Survivin protein expression inproliferative phase and secretory phase in OMES cells, which indicates that itsexpression is cycle-independent. These findings show that the enhancedanti-apoptotic ability of eutopic and ectopic endometrium in EMT than normal endometrial may realized through increased survivin protein expression, whichpromotes endometrium to survive and metastasis after detaching from theuterine cavity.2.The periodic expression of Bcl-2protein in normal endometrium plays animportant role in maintaining the regularity of the menstrual cycle. Higher Bcl-2expression enhanced the anti-apoptotic capacity of eutopic endometrium andectopic endometrial, broke the balance of survival and apoptosis of endometrialcells, decreased apoptosis rate, prolonged cell cycle and promoted ectopic focidevelopment. The findings suggest that higher Bcl-2expression enhanced theanti-apoptotic capacity of eutopic endometrium and ectopic endometrial, brokethe balance of survival and apoptosis of endometrial cells, decreased apoptosisrate, prolonged cell cycle and promoted ectopic foci development.3.The study showed that there was low expression of Survivin protein andBcl-2protein in normal endometrium and high in ectopic endometrium, whichsuggest that Survivin protein and Bcl-2protein may act synergistically in theinhibition of cell apoptosis and promote the occurrence and progression ofendometriosis.