PROGNOSTIC VALUE OF BCL-2 EXPRESSION IN PATIENTS WITH OPERABLE CARCINOMA OF THE UTERINE CERVIX

Aim-To evaluate the patterns of bcl-2 expression in early stage cervic al carcinoma; to compare bcl-2 expression with clinicopathological fin dings; and to assess its prognostic value. Methods-Wertheim radical hy sterectomy specimens from 76 patients (FIGO stages Ia-IIb) with untrea ted nonmetastatic invasive cervical carcinoma were studied. Expression of bcl-2 was detected immunohistochemically using a monoclonal antibo dy. A tumour was regarded as positive when more than 5% of the neoplas tic cells exhibited bcl-2 immunoreactivity. Results-Forty eight (63%) cervical carcinomas were scored as bcl-2 positive and 28 (37%) as bcl- 2 negative. Most tumours showed heterogeneous cytoplasmic staining. Bc l-2 immunoreactivity did not correlate with tumour histology, tumour s tage, presence of lymph node metastases, or involvement of the lymphov ascular space. The five year survival rate for patients with bcl-2 neg ative tumours was 34% and was 71% for patients with bcl-2 positive tum ours. On multiple regression analysis (Cox proportional hazards model) , bcl-2 expression and vascular permeation were independent predictors of overall survival. Conclusions-Bcl-2 expression seems to be associa ted with less aggressive behaviour in early stage cervical carcinoma. The transition to bcl-2 independence may play an important role in tum our progression.