BCL-2 and PAX2 Expressions in EIN which Had Been Previously Diagnosed as Non-Atypical Hyperplasia
- 223 Downloads
The relationship between PAX2 and another anti-apoptotic gene, BCL-2, has been shown in a limited number of studies. The aims of this study are to investigate the value of PAX2 and BCL-2 expressions in lesions which have been defined as nonatypical hyperplasia in terms of detecting EIN and to evaluate the relations of these proteins in EIN. For this purpose, 108 cases of non-atypical endometrial hyperplasia diagnosed from 2006 to 2011 were re-evaluated. Immunohistochemical studies with PAX2 and BCL-2 were performed in 20 cases with EIN and 34 cases with benign hyperplasia. The mean BCL-2 immunohistochemistry scores of benign hyperplasia and EIN cases were 4.06 ± 1.04 and 4.63 ± 2.03, respectively. The mean BCL-2 score of EIN cases was significantly higher than benign hyperplasia (p = 0.021). The mean PAX2 scores of benign hyperplasia and EIN cases were 4.32 ± 1.07 and 2.19 ± 2.34, respectively. The mean PAX2 scores of EIN cases were significantly lower than benign hyperplasia (p = 0.001). BCL-2 expression was increased compared to normal endometrium in 66.7% of EIN cases, and PAX2 expression was decreased in 73.3%. Consistent with this, in 60% of cases, BCL-2 expression was increased compared to normal endometrium, while PAX2 expression was decreased. BCL-2 and PAX2 protein expression changes occur in early phases of endometrial tumorigenesis. These changes are often seen as a simultaneous increase in BCL-2 expression and decrease in PAX2 expression.
KeywordsEndometrial intraepithelial neoplasia PAX2 BCL-2 Immunohistochemistry Uterus Endometrial hyperplasia
This work was supported by a research grant (Project No: GO KAEK 2016/194) from the Kocaeli University Division of Scientific Research Projects (KOÜBAPB, abbreviation in Turkish).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 2.Mutter GL, Baak JP, Crum CP et al (2000) Endometrial precancer diagnosis by histopathology, clonal analysis, and computerized morphometry. J Pathol 190:462–469. https://doi.org/10.1002/(SICI)1096-9896(200003)190:4<462::AID-PATH590>3.0.CO;2-D CrossRefGoogle Scholar
- 3.Mutter GL, Chaponot ML, Fletcher JA (1995) A polymerase chain reaction assay for non-random X chromosome inactivation identifies monoclonal endometrial cancers and precancers. Am J Pathol 146:501–508Google Scholar
- 4.Baak JP, Mutter GL, Robboy SJ et al (2005) The molecular genetics and morphometry-based endometrial intraepithelial neoplasia classification system predicts disease progression in endometrial hyperplasia more accurately than the 1994 World Health Organization classification system. Cancer 103:2304–2312. https://doi.org/10.1002/cncr.21058 CrossRefGoogle Scholar
- 7.Kapucuoglu N, Aktepe F, Kaya H et al (2007) Immunohistochemical expression of PTEN in normal, hyperplastic and malignant endometrium and its correlation with hormone receptors, bcl-2, bax, and apoptotic index. Pathol Res Pract 203:153–162. https://doi.org/10.1016/j.prp.2007.01.003 CrossRefGoogle Scholar
- 8.Kokawa K, Shikone T, Otani T, Nakano R (1999) Apoptosis and the expression of Bax and Bcl-2 in squamous cell carcinoma and adenocarcinoma of the uterine cervix. Cancer 85:1799–1809. https://doi.org/10.1002/(SICI)1097-0142(19990415)85:8<1799::AID-CNCR21>3.0.CO;2-M CrossRefGoogle Scholar
- 10.Stuart ET, Gruss P (1996) PAX: developmental control genes in cell growth and differentiation. Cell Growth Differ 7:405–412Google Scholar
- 17.Zaino RJ, Carinelli S, Ellenson LH, et al (2014) Tumours of the uterine corpus: epithelial tumours and precursors. In: Kurman RJ, Carcangiu M, Herrington C, Young R (eds) WHO Classif. Tumours female Reprod. Organs, 4th ed. WHO Press, Lyon, pp 125–126Google Scholar
- 20.Allred DC, Harvey JM, Berardo M, Clark GM (1998) Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol 11:155–168Google Scholar
- 23.Bozkurt KK, Yalcin Y, Erdemoglu E et al (2016) The role of immunohistochemical adrenomedullin and Bcl-2 expression in development of type-1 endometrial adenocarcinoma Adrenomedullin expression in endometrium. Pathol Res Pract 212:450–455. https://doi.org/10.1016/j.prp.2016.02.021 CrossRefGoogle Scholar
- 24.Amalinei C, Cianga C, Balan R et al (2011) Immunohistochemical analysis of steroid receptors, proliferation markers, apoptosis related molecules, and gelatinases in non-neoplastic and neoplastic endometrium. Ann Anat - Anat Anzeiger 193:43–55. https://doi.org/10.1016/j.aanat.2010.09.009 CrossRefGoogle Scholar