Mirakhor Samani Simin, Ezazi Bojnordi Tahmineh, Zarghampour Manijeh, Merat Sobhan, Fouladi Daniel F
a Department of Pathology , Qazvin University of Medicine Sciences , Qazvin , Iran.
b Department of Obstetrics and Gynecology , Mostafa Khomeini Hospital , Tabas , Iran.
J Obstet Gynaecol. 2018 Oct;38(7):999-1004. doi: 10.1080/01443615.2018.1437717. Epub 2018 Mar 21.
Our objective was to examine the expression rates of p53, Bcl-2 and Bax in endometrial carcinoma, endometrial hyperplasia and normal endometrium. A total of 94 endometrial frozen sections (carcinoma 48, hyperplasia 21, normal tissue 25) were examined immunohistochemically in terms of the expression rates of p53, Bcl-2 and Bax. All of the specimens in the non-malignant groups were positive for Bax, whereas this rate was 85.4% in the group with malignant specimens (p = .03). Conversely, p53 was expressed only in the cancerous group (77.1%, p < .001). The Bcl-2 expression rate was 54.2% in the cancer group, 76.2% in the group with hyperplasia and 60% in the group containing normal tissue (p = .23). Comparing to the non-malignant specimens, the mean Bcl-2/Bax were significantly higher in the malignant group. In conclusion, Bax under-expression, p53 over-expression and a high Bcl-2 to Bax ratio might be associated with endometrial carcinoma. Bcl-2, however, plays no significant role in this regard. Impact statement What is already known on this subject? The p53, Bcl-2 and Bax are the three major genes that regulate apoptosis. Some studies have suggested that these genes may play a role in the pathogenesis of endometrial carcinoma. The available reports, however, are old and inconclusive. What do the results of this study add? Comparing immunohistochemically obtained p53, the Bcl-2 and Bax expression rates between normal endometrial tissue, endometrial specimens with endometrial hyperplasia and specimens with carcinoma showed that Bax under-expression, p53 over-expression and a high Bcl-2 to Bax ratio were associated with malignancy. Using an up-to-date technique to examine the three major regulators of apoptosis at the same time, in a rather large sample size of both normal and abnormal endometrial tissue specimens simultaneously, are the major advantages of the present work. What are the implications of these findings for clinical practice and/or further research? According to our findings, the status of p53, Bcl-2 and Bax expression in the endometrial tissue can be used for risk stratification of endometrial carcinoma for both screening and preventive purposes.
我们的目的是检测p53、Bcl-2和Bax在子宫内膜癌、子宫内膜增生及正常子宫内膜中的表达率。采用免疫组织化学方法检测了94例子宫内膜冰冻切片（48例癌组织、21例增生组织、25例正常组织）中p53、Bcl-2和Bax的表达率。非恶性组的所有标本Bax均呈阳性，而恶性标本组的这一比例为85.4%（p = 0.03）。相反，p53仅在癌组织组表达（77.1%，p < 0.001）。癌组织组Bcl-2表达率为54.2%，增生组织组为76.2%，正常组织组为60%（p = 0.23）。与非恶性标本相比，恶性组Bcl-2/Bax的平均值显著更高。总之，Bax低表达、p53高表达以及高Bcl-2/Bax比值可能与子宫内膜癌有关。然而，Bcl-2在这方面未发挥显著作用。影响声明关于该主题已知的信息有哪些？p53、Bcl-2和Bax是调节细胞凋亡的三个主要基因。一些研究表明这些基因可能在子宫内膜癌的发病机制中起作用。然而，现有报告年代久远且结论不明确。本研究结果有何补充？通过免疫组织化学比较正常子宫内膜组织、子宫内膜增生标本和癌组织标本中p53、Bcl-2和Bax的表达率，结果显示Bax低表达、p53高表达以及高Bcl-2/Bax比值与恶性肿瘤有关。本研究的主要优势在于使用最新技术同时检测细胞凋亡的三个主要调节因子，且样本量较大，涵盖了正常和异常的子宫内膜组织标本。这些发现对临床实践和/或进一步研究有何意义？根据我们的研究结果，子宫内膜组织中p53、Bcl-2和Bax的表达状态可用于子宫内膜癌的风险分层，以进行筛查和预防。
