title: An immunohistochemical comparison of P53 and Bcl-2 as apoptotic and MIB1 as proliferative markers in low-grade and high-grade ovarian serous carcinomas.
abstract: BACKGROUND
  Traditionally, ovarian serous carcinomas (OSCs) have been graded using a 3-tiered system, as well differentiated, moderately differentiated, and poorly differentiated. Recently, a 2-tiered system has been proposed depending on the nuclear atypia and mitotic count. The dualistic pathway of ovarian serous carcinogenesis with accumulating molecular genetic evidence forms the basis for this grading system.
  
  
  OBJECTIVE
  To investigate the expression of apoptotic proteins, p53 and bcl-2, and MIB1 index in low-grade and high-grade OSCs.
  
  
  METHODS
  Eighteen cases of low-grade OSCs and 28 cases of high-grade OSCs were stained immunohistochemically with antibodies against p53, bcl-2, and MIB1. For p53 and bcl-2, staining was evaluated on a semiquantitative scale depending on the number of cells showing positivity. For MIB1, the percentage of positive nuclei was calculated.
  
  
  RESULTS
  Of 28 cases of high-grade OSCs, 15 (53.6%) showed 5+ staining with p53 compared with 3 (16.7%) of 18 cases of low-grade OSCs. Of 28 cases of high-grade OSCs, 10 (35.7%) showed 5+ staining with bcl-2 compared with 2 (11.1%) of 18 cases of low-grade OSCs. The mean MIB1 index was 42.1% in high-grade OSCs (range, 10%-90%) in contrast to the 19.4% (range, 10%-40%) in low-grade OSCs. The differences in apoptotic protein expression and proliferative index between the low-grade and high-grade OSCs were statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  The expression of apoptotic markers is higher in high-grade OSCs, which also have a higher proliferative activity compared with those in low-grade OSCs, which supports the dualistic pathway of ovarian serous carcinogenesis.
authors.affiliation: Department of Pathology, St John's Medical College, Bangalore, Karnataka, India.
authors.forename: Suniti K
authors.initials: SK
authors.lastname: Mishra
authors.forename: Julian A
authors.initials: JA
authors.lastname: Crasta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000378:metabolism*; D049109:Cell Proliferation; D018284:Cystadenocarcinoma, Serous / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000378:metabolism* / Q000473:pathology; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism*; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*; D044767:Ubiquitin-Protein Ligases / Q000378:metabolism*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D019253:Proto-Oncogene Proteins c-bcl-2; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; C513496:MIB1 ligase, human; D044767:Ubiquitin-Protein Ligases