Abstract
The etiology of endometriosis is highly complex, and although it is a benign disease, it has several biological behaviors similar to malignant lesions, including cell invasion, neo-angiogenesis, and decreased apoptosis. Survivin is a protein encoded by the BIRC5 gene that plays a role in cell division by inhibiting apoptosis and regulating the process of mitosis in embryonic and cancer cells. Therefore, we aimed to evaluate the expression of BIRC5 in samples of peripheral blood of women with and without endometriosis. This study comprised of 40 women with endometriosis and 10 healthy women as controls. Peripheral blood samples were collected in the three phases of the menstrual cycle (follicular, ovulatory, and luteal). The expression of the BIRC5 gene was evaluated by RT-qPCR using the TaqMan methodology. The BIRC5 expression was significantly higher in all phases of the menstrual cycle in women with endometriosis, regardless of the disease stage. The accuracy of BIRC5 expression in the peripheral blood for the diagnosis endometriosis presented AUC of 0.887 (p < 0.001), with 97.2% of sensitivity and specificity of 65.5% considering the overall endometriosis group. Regarding the minimal/mild endometriosis group, the AUC presented a value of 0.925 (p < 0.001), with 100% of sensitivity and 79.3% of specificity, whereas in the moderate/severe endometriosis group the AUC was 0.868 (p < 0.001), with a sensitivity of 95.8% and specificity of 65.5%. These findings suggest that the expression of BIRC5 may be a potential noninvasive biomarker for the diagnosis of endometriosis.
Highlights
Endometriosis is a common estrogen-dependent gynecological condition, which can affect women at a reproductive age [1]
The BIRC5 expression was significantly higher in all phases of the menstrual cycle in women with endometriosis
Homeostasis maintenance of tissue is mainly regulated by cell death and some studies have shown that apoptosis increases during the menstrual cycle to retain cell homeostasis, removing aged cells from the functional layer of the endometrium [33]
Summary
Endometriosis is a common estrogen-dependent gynecological condition, which can affect women at a reproductive age [1] It is defined as the presence of endometrial-like tissue outside of the uterus, often associated with chronic and inflammatory reaction [2]. Cancer antigen 125 (CA125) plasma concentrations, a glycoprotein of epithelial origin, largely used, are not reliable to diagnose endometriosis. It may be elevated in several benign diseases and patients with non-ovarian malignancies, including cancers of the endometrium, lung, breast, pancreas, and colon [5], and it has no value in the diagnosis as a single test [3]. As the surgery presents risks and a high cost, a less invasive, but accurate test could lead to the diagnosis of the disease without the need for surgery, or at least it could help reduce the need for a surgical procedure for its confirmation [3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
