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<p>Abstract</p> <p>Background</p> <p>It has been suggested that the B-cell specific moloney leukemia virus insertion site 1 (Bmi-1) gene plays an oncogenic role in several types of human cancer, but the status of <it>Bmi-1 </it>amplification and expression in ovarian cancer and its clinical/prognostic significance are unclear.</p> <p>Methods</p> <p>The methods of immunohistochemistry and fluorescence <it>in situ </it>hybridization were utilized to examine protein expression and amplification of <it>Bmi-1 </it>in 30 normal ovaries, 30 ovarian cystadenomas, 40 borderline ovarian tumors and 179 ovarian carcinomas.</p> <p>Results</p> <p>Intensive expression of Bmi-1 was detected in none of the normal ovaries, 3% cystadenomas, 10% borderline tumors, and 37% ovarian carcinomas, respectively. Amplification of <it>Bmi-1 </it>was detected in 8% of ovarian carcinomas. In ovarian carcinomas, significant positive associations were found between intensive expression of Bmi-1 and the tumors ascending histological grade, later pT/pN/pM and FIGO stages (<it>P </it>< 0.05). In univariate survival analysis of the ovarian carcinoma cohorts, a significant association of intensive expression of Bmi-1 with shortened patient survival (mean 49.3 months <it>versus </it>100.3 months, <it>p </it>< 0.001) was demonstrated. Importantly, Bmi-1 expression provided significant independent prognostic parameters in multivariate analysis (<it>p </it>= 0.005).</p> <p>Conclusions</p> <p>These findings provide evidence that intensive expression of Bmi-1 might be important in the acquisition of an invasive and/or aggressive phenotype of ovarian carcinoma, and serve as a independent biomarker for shortened survival time of patients.</p>