Surviving Gene Expression and Progression of Cervical Intraepithelial Neoplasia: A Systematic Review with Meta-Analysis

The relationship between survivin expression and Cervical Intraepithelial Neoplasia (CIN) remains controversial. We evaluate the potential role of survivin in tumorigenesis and progression of CIN. Related articles were searched of PubMed, EMBASE, pmc, sciencederaction library, Wanfang, VIP, CNKI from January 2002 to May 2012. Meta-Analyst Beta 3.13 was applied to pool eligible studies and summary odds ratio (OR). We performed a final analysis of 717 patients from 9 studies. Combined OR of CIN1-2 and CIN2-3 suggests that survivin expression becomes higher with disease progression (OR = 3.117, 95% CI: 1.797-5.409, P <; 0.001; OR = 3.919, 95% CI: 2.332-6.586, P <; 0.001). Combined OR of CIN1-2 in strong positive expression level and CIN2-3 in weak and intense positive expression level suggests that survivin expression has correlation with CIN1-2 in positive level and CIN2-3 in weak and intense level(OR=2.191, 95%CI: 1.057-4.545, P = 0.043; OR=0.504, 95%CI: 0.274-0.927, P = 0.035; OR= 4.829, 95%CI: 2.905-8.026, P <; 0.001). Whereas, survivin expression has no correlation with CIN1-2 in weak and moderate expression level and CIN2-3 in moderate expression level. This study shows that survivin expression seems to be associated with progression of CIN.