Role of Survivin Expression in Cervical Intraepithelial Neoplasia and Its Implications for Cervical Carcinogenesis

Background and Aims: Cervical intraepithelial neoplasia (CIN) is a precursor to cervical cancer, driven by human papillomavirus (HPV) infection. Survivin, an inhibitor of apoptosis protein, is implicated in cancer progression by inhibiting programmed cell death. This study aimed to evaluate survivin expression in CIN and invasive cervical lesions, assess its association with lesion severity, and explore its potential as a biomarker for early diagnosis and therapeutic targeting. Materials and Methods: A cross-sectional study was conducted at Dhanalakshmi Srinivasan Medical College and Hospital from 2018 to 2021, involving 100 cervical tissue samples (CIN I-III, squamous cell carcinoma [SCC], adenocarcinoma, and controls). Survivin expression was assessed via immunohistochemistry, with nuclear staining considered positive. Data on demographics, histological diagnosis, and staging were collected. Statistical analysis used SPSS version 22, employing Chi-square tests and Fisher’s exact tests. Results: Survivin expression was observed in 25% of CIN I, 45% of CIN II, 58% of CIN III, and 68% of SCC cases. Expression significantly increased with lesion severity (p<0.001). Survivin positivity was higher in invasive cancers (68%) compared to CIN (46%). No significant correlation was found with age or HPV status. Conclusion: Survivin expression escalates with CIN progression and is prominent in invasive cervical lesions, suggesting its role in cervical carcinogenesis. It holds promise as a diagnostic biomarker and potential therapeutic target. Further studies are needed to validate its prognostic utility.