Evaluation of Survivin Expression in the Endometrium and Endometriotic Lesions in Patients with Genital Endometriosis, Type 1 Diabetes Mellitus and Their Comorbidity

BACKGROUND: The prevalence of external genital endometriosis is high, yet there is insufficient understanding of its etiology and pathogenesis. This coupled with the challenges posed by its diagnosis and treatment, and its co-occurrence with type 1 diabetes mellitus, underscores the significance of this issue. AIM: The aim of this study was to evaluate the expression of survivin in the eutopic endometrium, endometriotic lesions, and their concomitant conditions in patients with external genital endometriosis and type 1 diabetes mellitus. MATERIALS AND METHODS: This study enrolled 43 female patients of reproductive age who were divided into four groups. The main group (n = 17) included women with surgically and histologically confirmed external genital endometriosis combined with type 1 diabetes mellitus. The external genital endometriosis group (n = 9) comprised women with isolated external genital endometriosis, while the type 1 diabetes mellitus group (n = 6) included patients with type 1 diabetes mellitus only. Finally, the control group (n = 6) consisted of women without any gynecological pathology. Biological specimens were collected during the follicular phase of the menstrual cycle, and morphological examination was carried out through histological and immunohistochemical evaluation of the endometrium and endometrioid heterotopias. Statistical analysis of the data was performed using the Jamovi software program, with statistical significance defined as p 0.05. RESULTS: Our findings indicate that patients with external genital endometriosis and comorbid type 1 diabetes mellitus exhibit a statistically significant increase in survivin expression in the endometrium compared to the control group or patients with type 1 diabetes mellitus only. However, no significant difference was observed in survivin expression in endometriotiс lesions between patients with external genital endometriosis and those with external genital endometriosis combined with type 1 diabetes mellitus. CONCLUSIONS: The data obtained suggest the role of survivin in the pathogenesis of external genital endometriosis, regardless of the presence of type 1 diabetes mellitus.