Virchows Archiv

, Volume 461, Issue 5, pp 589–599

Survivin, MMP-2, MT1-MMP, and TIMP-2: their impact on survival, implantation, and proliferation of endometriotic tissues


  • Ambrogio P. Londero
    • Clinic of Obstetrics and GynecologyUniversity of Udine
    • Clinic of Obstetrics and GynecologyUniversity of Udine
  • Tiziana Grassi
    • Clinic of Obstetrics and GynecologyUniversity of Udine
  • Stefania Marzinotto
    • Institute of PathologyUniversity of Udine
  • Maria Orsaria
    • Institute of PathologyUniversity of Udine
  • Carlo Alberto Beltrami
    • Institute of PathologyUniversity of Udine
  • Diego Marchesoni
    • Clinic of Obstetrics and GynecologyUniversity of Udine
  • Laura Mariuzzi
    • Institute of PathologyUniversity of Udine
Original Article

DOI: 10.1007/s00428-012-1301-4

Cite this article as:
Londero, A.P., Calcagno, A., Grassi, T. et al. Virchows Arch (2012) 461: 589. doi:10.1007/s00428-012-1301-4


In order to study survivin, matrix metalloproteinases (MMP-2), membranous type 1 matrix metalloproteinase (MT1-MMP), and tissue inhibitor metalloproteinase-2 (TIMP-2) expression immunohistochemically in endometriotic tissues and normal endometrium, our retrospective study considered 194 patients affected by endometriosis and 71 patients with normal endometrium. Tissue microarrays were created from paraffin-embedded blocks; immunohistochemistry was used to assess protein expression. In endometriotic tissues, survivin was expressed at a higher level than in normal endometrium; its glandular expression level was higher in non-ovarian than in ovarian endometriotic tissues and lower in stromal components. Endometrial tissues from women without endometriosis and endometriotic tissues had different matrix metalloproteinase expression profiles. MMP-2 and MT1-MMP correlated with TIMP-2 in endometriotic tissues. Furthermore, in endometriotic tissues, expression of survivin, aurora B kinase, and Ki-67 showed a significant positive correlation, which indicates a role in cellular proliferation that could be closely linked to its anti-apoptotic activity in endometriosis development. Our results imply a role for matrix metalloproteinases in endometriosis invasiveness; correlation of their expression with that of TIMP-2 underscores its possible key regulatory role.


EndometriosisSurvivinMatrix metalloproteinase-2Membranous type 1 matrix metalloproteinaseTissue inhibitor metalloproteinase-2Tissue microarrays



Aurora B kinase


Adenomatous polyposis coli


American Society of Reproductive Medicine


Endometriotic tissue


Inhibitor of apoptosis protein


Interquartile range


Matrix metalloproteinase-2


Matrix metalloproteinase


Membranous type 1 matrix metalloproteinase


Progesterone receptor


Tissue inhibitor metalloproteinase-2


Tissue microarray

Supplementary material

428_2012_1301_MOESM1_ESM.pdf (215 kb)
ESM 1(PDF 215 kb)

Copyright information

© Springer-Verlag 2012