Survivin expression in ovarian carcinoma and its role as apoptotic inhibitor and prognostic predictor

Abstract

Background: Most ovarian cancers are diagnosed at advanced stages due to the lack of specific symptoms and lack of efficient screening methods. It is very important to examine prognostic predictor factors to increase survival rates. Survivin is a protein that plays a key role in inhibiting the process of programmed cell death or apoptosis, which will cause increased mitosis and cell proliferation as well as a worse prognosis. This study aims to prove the role of survivin as an inhibitor of apoptosis and predict prognosis by proving the existence of an association between survivin expression and mitotic index and proving the difference in survivin expression in type I and type II ovarian carcinoma. Methods: A cross-sectional analytical observational study, a total sample of 40, taken from surgical specimens from ovarian carcinoma patients whose tissues were examined at the Anatomical Pathology Laboratory Faculty of Medicine Universitas Udayana/ Prof. dr. I G.N.G. Ngoerah Hospital Denpasar. Histopathological diagnosis and mitotic index were performed using H & E staining. Survivin expression was evaluated by immunohistochemical staining. Data analysis using chi-square test, significance value of p < 0.05. Results: The mean age for type I ovarian carcinoma was 47.75 ± 11.50, and type II was 55.30 ± 6.11. The chi-square test shows a significant difference in survivin expression (p = 0.009) and in mitotic index (p = 0.001) of type I and type II ovarian carcinoma. A significant association was also found between survivin expression and mitotic index in type I (p = 0.046) and in type II ovarian carcinoma (p = 0.018). Conclusion: There was a significant association between survivin expression and mitotic index and differences in survivin expression in type I and type II ovarian carcinoma.