Expression of PTEN and survivin in cervical cancer: promising biological markers for early diagnosis and prognostic evaluation

Abstract

ABSTRACTThis study aims to evaluate the expression of the antioncogene phosphatase and tensin (PTEN) homologue and survivin, a protein encoded by the anti-apoptotic gene baculoviral inhibitor of apoptosis repeat containing 5 (BIRC5), in the progression of cervical neoplasia and to elucidate the relationship between PTEN and survivin expression based on clinicopathological features in squamous cell carcinoma of the uterine cervix. A total of 20 patients with cervical ectropion and squamous metaplasia, 30 with cervical intraepithelial neoplasia, and 49 with cervical squamous cell carcinoma were enrolled in the study. Immunohistochemical staining was performed to detect PTEN and survivin expression in each group. Normal cervical epithelium from 10 people served as the control. Results showed that PTEN expression progressively decreased with the continuum from normal epithelium to squamous cell carcinoma (P<0.05), whereas survivin expression progressively increased (P<0.05). Furthermore, positive PTEN immunostaining was associated with clinical stage and tumour size (P<0.05). The level of PTEN expression in the metastatic pelvic lymph node group was significantly lower compared with the non-metastatic pelvic lymph node group (P<0.01). Positive PTEN immunostaining was not associated with age or degree of differentiation (P>0.05). Positive survivin immunostaining was associated with clinical stage and tumour size (P<0.05). Survivin-positive expression in the metastatic pelvic lymph node group was significantly higher compared with the non-metastatic pelvic lymph node group (P<0.01). No obvious relationship was found between survivin expression and patient age (P>0.05). PTEN expression negatively correlated with survivin expression in cervical intraepithelial neoplasia and cervical squamous cell carcinoma (P<0.01). PTEN and survivin expression correlated with incidence and progression of uterine cervical cancer. Positive expression levels of PTEN and survivin provide potential evaluation indices for early diagnosis and prognosis of uterine cervical cancer, and these biomarkers are also potentially promising therapeutic targets.