The possible role of p53 and bcl-2 expression in cervical carcinomas and their premalignant lesions.
OBJECTIVE
The purpose of this study was to assess the expression and clinical significance of bcl-2 and p53 in the progression of cervical neoplasias.


METHODS
One hundred seventy-one cervical specimens, consisting of normal cervical epithelium (n = 13), lesions with histological features of HPV infection (n = 14), CIN (cervical intraepithelial neoplasia) lesions (n = 63), and cervical carcinomas (n = 81) were examined immunohistochemically in paraffin sections.


RESULTS
Twenty-three specimens showed p53 expression [3/20 (15%) CIN III, 18/63 (29%) ISCC (invasive squamous cervical carcinoma), and 2/18 (11%) adenocarcinomas] while 63 cases expressed the bcl-2 gene [10/13 (77%) normal, 0/14(0%) condylomas, 6/23 (26%) CIN I, 9/20 (45%) CIN II, 15/20 (75%) CIN III, 18/63 (29%) ISCC, and 5/18 (28%) adenocarcinomas]. The expression of bcl-2 was found to increase in direct relation to the grade of CIN (P = 0.02) whereas such a trend was not observed for p53. p53 was not detected in normal or premalignant lesions (except 3 out of 20 cases of CIN III). There was no significant correlation between the expression of p53 and the histological type of cervical carcinoma, even though expression of p53 was higher in ISCC than in adenocarcinomas (29% vs 11%, respectively). In cervical cancer patients, expression of bcl-2 was correlated to a greater than 5-year survival (P < 0.01) while no prognostic significance of p53 expression was found.


CONCLUSIONS
Evaluation of bcl-2 expression may provide additional and independent prognostic information for the clinical course of the disease and therefore to be developed as a prognostic indicator for cervical cancer.
Dimitrakakis
C
C
First Department of Gynecology & Obstetrics, Athens Medical School, Athens, Greece. androniki@hellasnet.gr
Kymionis
G
G
Diakomanolis
E
E
Papaspyrou
I
I
Rodolakis
A
A
Arzimanoglou
I
I
Leandros
E
E
Michalas
S
S
D000230:Adenocarcinoma / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D002278:Carcinoma in Situ / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000150:complications; D011230:Precancerous Conditions / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis*; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis*; D002583:Uterine Cervical Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology
D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53