Survivin and Ki-67 expression in leiomyomas, leiomyoma variants, leiomyosarcoma, and STUMP : An immunohistochemical and clinical follow-up study

Abstract

Aim: Survivin is an “inhibitor of apoptosis” protein. Survivin expression is a poor prognostic factor in a variety of solid tumors. In thisclinicopathological study, we aimed to investigate survivin immunostaining of leiomyomas, leiomyoma variants, STUMP (Uterinesmooth muscle tumor of uncertain malignant potential)’s and LMS (leiomyosarcoma). Our second objective was to investigatewhether survivin immunoreactivity in STUMP and LMS may play a role in determining recurrence.Material and Methods: Consecutive 119 specimens of leiomyoma, leiomyoma variants, STUMP and LMS from the pathology archivesof Bezmialem Medical Faculty and Cerrahpasa Medical Faculty were selected. Clinicopathologic characteristics were analyzed andspecimens were stained with survivin and Ki-67. The percentage and staining intensity of immunoreactive cells were examined.Additionally, we analyzed whether survivin intensity and expression might be a predictor of LMS recurrence.Results: The patients in the LMS group were older (p< 0.001). All LMS and all STUMP specimens were stained with survivin. Survivinstaining and Ki-67 staining were highest in the LMS and STUMP groups. Survivin staining was 14.2 ± 6.7 % in the LMS group, 11.2±10.4 % in the STUMP group, 1.85 ± 1.9 % in the leiomyoma group and 1.4 ± 0.2 % in the leiomyoma variant group (p