title: The use of an immunocytochemical double-labeling staining can display the distribution of Bcl-2/Ki-67 cells in endometrial adenocarcinomas as well as in normal endometrium.
abstract: BACKGROUND
  Endometrial adenocarcinoma is the most common gynecologic malignancy and is the fifth most frequently diagnosed cancer in women. The objective of the present study was to determine the expression of a proliferation marker, Ki-67 and an apoptosis inhibitor, Bcl-2, by double-label staining in endometrial adenocarcinomas and in normal endometrium samples, to evaluate the differences in the immunocytochemical expression of Ki-67 and Bcl-2, and finally to correlate the results with tumor grade and stage.
  
  
  METHODS
  This study was carried on 270 endometrial samples, collected during a 27 month period, freshly resected from women who underwent total abdominal hysterectomy.
  
  
  RESULTS
  Ki-67 and Bcl-2 expressions were studied by immunocytochemistry. Bcl-2 expression was strong and homogeneous in normal (proliferative, secretory and atrophic) endometrium and more frequent in low-grade endometrioid carcinomas. Completely negative staining of Bcl-2 was found to be strictly related to high-grade endometrioid carcinomas. Ki-67 expression was higher in patients with high-grade endometrioid carcinomas. Proliferative endometrium showed inconclusive Ki-67 expression levels and in the secretory endometrium Ki-67 positive cells were remarkably diminished and even disappeared. Completely negative staining of Ki-67 was found to be strictly related to atrophic endometrium.
  
  
  CONCLUSIONS
  Immunocytochemical double-label staining can be used to display the distribution of Bcl-2 and Ki-67 cells in endometrioid carcinomas as well as normal endometrium, and, in addition to cytomorphologic features, contributes to its accurate diagnosis.
authors.affiliation: Department of Cytopathology, "ATTIKON" University Hospital, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Mourtzikou
authors.forename: K
authors.initials: K
authors.lastname: Kosmas
authors.forename: A
authors.initials: A
authors.lastname: Marouga
authors.forename: M
authors.initials: M
authors.lastname: Stamouli
authors.forename: A
authors.initials: A
authors.lastname: Pouliakis
authors.forename: P
authors.initials: P
authors.lastname: Karakitsos
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D018269:Carcinoma, Endometrioid / Q000378:metabolism / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000378:metabolism / Q000473:pathology*; D004717:Endometrium / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008875:Middle Aged; D009367:Neoplasm Staging; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2