Protrka Z, Djurić J, Protrka O, Arsenijević S
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia.
J BUON. 2010 Apr-Jun;15(2):323-9.
To assess the expression of Bcl-2 protooncogene in premalignant and malignant uterine cervix lesions.
To establish the role of this protooncogene in uterine cervix carcinogenesis, we examined 69 tissue samples of low grade cervical squamous intraepithelial lesions (SIL) (n=16), high grade SIL (n=11), portio vaginalis uteri (PVU) carcinoma in situ (n=11) and PVU invasive carcinoma, stage IA-IIA (n=13) (study group) and 18 samples without SIL or malignancy (control group). The expression of Bcl-2 was detected immunohistochemically using a monoclonal antibody. Fisher's exact test (p <0.05) was used to assess statistical significance. By establishing the sensitivity and specificity of the test, the level of reliability of these analyses was determined as a possible screening method for early detection of changes in the uterine cervix.
Overexpression of Bcl-2 was found to increase in direct relation to the grade of the cervical lesions. Statistically significant difference was found in the frequency of overexpression in patients with high grade SIL (6/11, p=0.006), PVU carcinoma in situ (5/11, p=0.018) and PVU invasive carcinoma (6/13, p=0.012), in relation to the control group. High sensitivity was of great diagnostic significance for the detection of these types of changes in the uterine cervix. On the basis of high predictive values it can be said that in patients with Bcl-2 overexpression there is a great possibility that they have premalignant or malignant changes in the uterine cervix.
Our results indicate that overexpression of Bcl-2 may play an important role in cervical carcinogenesis. However, more extensive series of samples is required to establish the prognostic significance of Bcl-2 in cervical carcinogenesis.
评估Bcl-2原癌基因在子宫颈癌前病变和恶性病变中的表达。
为确定该原癌基因在子宫颈癌发生中的作用，我们检测了69份组织样本，其中包括低级别宫颈鳞状上皮内病变（SIL）（n = 16）、高级别SIL（n = 11）、阴道部子宫原位癌（PVU）（n = 11）以及PVU浸润癌IA-IIA期（n = 13）（研究组），还有18份无SIL或恶性病变的样本（对照组）。使用单克隆抗体通过免疫组织化学法检测Bcl-2的表达。采用Fisher精确检验（p <0.05）评估统计学意义。通过确定检测的敏感性和特异性，将这些分析的可靠性水平确定为子宫颈早期变化的一种可能的筛查方法。
发现Bcl-2的过表达与宫颈病变的级别直接相关。与对照组相比，高级别SIL患者（6/11，p = 0.006）、PVU原位癌患者（5/11，p = 0.018）和PVU浸润癌患者（6/13，p = 0.012）的过表达频率存在统计学显著差异。高敏感性对于检测子宫颈的这些类型变化具有重要的诊断意义。基于高预测值，可以说Bcl-2过表达的患者子宫颈发生癌前或恶性变化的可能性很大。
我们的结果表明，Bcl-2的过表达可能在子宫颈癌发生中起重要作用。然而，需要更广泛的样本系列来确定Bcl-2在子宫颈癌发生中的预后意义。
