Immunohistochemical detection of p53 and bcl-2 proteins in neoplastic and non-neoplastic endocervical glandular lesions.

The study examines p53 and bcl-2 protein expression in a variety of neoplastic and non-neoplastic endocervical glandular lesions. Immunohistochemical staining, using monoclonal antibodies against p53 (DO-7) and bcl-2, was performed on archival paraffin-embedded tissue following microwave antigen retrieval. With DO-7 there was positive nuclear staining in 23/33 cases of adenocarcinoma, 2/10 adenocarcinoma in situ, 2/10 tubo-endometrial metaplasia, 1/10 microglandular hyperplasia, and 1/17 normal endocervix. With adenocarcinoma in situ and non-neoplastic lesions, positive staining was confined to scattered cells. Nine of 23 positive cases of adenocarcinoma showed widespread staining. With anti-bcl-2 antibody, there was positive cytoplasmic staining in 9/33 cases of adenocarcinoma, 0/10 adenocarcinoma in situ, 7/10 tubo-endometrial metaplasia, 1/10 microglandular hyperplasia, and 0/17 normal endocervix. Five of nine positive adenocarcinomas showed widespread staining. There was widespread positive staining for bcl-2 in six of seven positive cases of tubo-endometrial metaplasia. The results indicate that p53 protein expression is frequent in endocervical adenocarcinoma and suggest that mutation of the p53 gene may be important in the evolution of some cases of endocervical adenocarcinoma. Scattered p53-positive cells may be seen in endocervical adenocarcinoma in situ and in non-neoplastic endocervical glandular lesions, the significance of which is uncertain. Bcl-2 protein expression is seen in a proportion of endocervical adenocarcinomas and may play a role in the evolution of these tumors through inhibition of apoptosis. Widespread positivity for bcl-2 protein is seen in most cases of tubo-endometrial metaplasia, suggesting that this type of metaplastic epithelium may represent an unusually stable population of cells.