Saegusa M, Kamata Y, Isono M, Okayasu I
Department of Pathology, Kitasato University, School of Medicine, Kanagawa, Japan.
J Pathol. 1996 Nov;180(3):275-82. doi: 10.1002/(SICI)1096-9896(199611)180:3<275::AID-PATH660>3.0.CO;2-A.
A total of 103 endometrial carcinomas (endometrioid type), as well as 15 samples of normal (atrophic or proliferative phase) and 26 of hyperplastic endometrium, were immunohistochemically investigated for expression of Bcl-2, and oestrogen and progesterone receptors (ER and PR), and the results compared with findings for apoptosis and cell proliferation. Carcinoma cases were subdivided into tubular and solid components on the basis of tumour growth patterns. Immunopositivity for Bcl-2, ER, and PR in tubular components was significantly higher than in the solid category, being negatively associated with histological grading. Immunoreactivity scores revealed that Bcl-2 in the tubular group was positively correlated with PR but not ER, while its expression in normal and hyperplastic endometrium was closely linked with both. Apoptotic and mitotic indices (AI and MI) were both significantly lower in tubular than in solid areas. In the tubular areas, AI, values were significantly lower in the subgroup with a high level of Bcl-2 expression than in either low-level or negative groups. These results indicate that Bcl-2 expression may play a central role in the inhibition of apoptosis in endometrial carcinoma, in particular those cases with tubular components, possibly being associated with PR rather than ER. Changes in the propensity for apoptosis may be related to alterations of tumour growth pattern and of features of differentiation.
对103例子宫内膜癌（子宫内膜样型）以及15例正常（萎缩期或增殖期）和26例增生期子宫内膜样本进行免疫组织化学研究，检测Bcl-2、雌激素和孕激素受体（ER和PR）的表达，并将结果与凋亡和细胞增殖的结果进行比较。根据肿瘤生长模式将癌病例分为管状和实性成分。管状成分中Bcl-2、ER和PR的免疫阳性率显著高于实性成分，且与组织学分级呈负相关。免疫反应性评分显示，管状组中Bcl-2与PR呈正相关，但与ER无关，而其在正常和增生期子宫内膜中的表达与两者均密切相关。管状区域的凋亡和有丝分裂指数（AI和MI）均显著低于实性区域。在管状区域，Bcl-2高表达亚组的AI值显著低于低表达或阴性组。这些结果表明，Bcl-2表达可能在子宫内膜癌尤其是具有管状成分的病例中对凋亡的抑制起核心作用，可能与PR而非ER相关。凋亡倾向的变化可能与肿瘤生长模式和分化特征的改变有关。
