The Expression Of Survivin In Endometriosis And The Regulation Effect Of Vascular Endothelial Growth Factor On Survivin Expression

Objective To find out how survivin, a novel member in the inhibitor of apoptosis proteins family, is expressed in the ectopic and eutopic endometrium from women with endometriosis (EM). To investigate the effect of vascular endothelial growth factor (VEGF) on survivin expression in isolated cultured human endometrial stromal cell.Method We observed survivin protein expression in the ectopic and eutopic endometrium from 38 EM patients and normal endometium from 20 women without EM by immunohistochemistry method. Then we isolated the stromal cell from 10 eutopic endometrium of EM patients, cultured them in medium RMPI 1640 with different concentration of VEGF. After 24 hours, we checked the expression of survivin at protein and gene level with immunohistochemistry and RT-PCR method respectively.Resits 1) Survivin expression could be observed in both ectopic and eutopic endometrium from patients with endometriosis and was lack of cyclic changes (P>0.05). Compared with eutopic endometrium, survivin expression in ectopic lesion has a significantly larger quantity (P<0.05). 2) Survivin expression in glandular epithelium of pelvic endometriosis was positively correlated with the clinical stages of disease (P<0.05) but not serumal CA125 level (P>0.05) which was also proved to be irrelavant with clinical stages (P>0.05).Survivin expression in lesions of stage â…¢ and â…£ were stronger than in those of stage â…  and â…¡ (P<0.05). 3) Inside ectopic lesion in ovary, survivin expression intensity inectopic glandular epithelium is positively correlated with that in stroma (P<0.05). 4) After being cultured in vitro with different concentration of VEGF for 24 hours, stromal cell from uterus of EM patients showed changes of survivin expression both at protein level and gene level. As the concentration of VEGF increased, survivin expression was enhanced at translation level (P<0.05) while declined at transcription level (P<0.05).Conclusions Survivin expression can be observed in various location of ectopic endometrium and is positively correlated with clinical stages. Both eutopic and ectopic endometium of endometriosis patients show little changes during the menstrual cycle. In ectopic lesion, survivin expression in glandular epithelium is positively correlated with that in stroma. CA125 has poor correlation with both survivin expression and clinical stages. The regulation ofVEGF on survivin expression is complicated and need further investigation.