The possible role of p53 and bcl-2 expression in cervical carcinomas and their premalignant lesions

Objective. The purpose of this study was to assess the expression and clini cal significance of bcl-2 and p53 in the progression of cervical neoplasias . Methods. One hundred seventy-one cervical specimens, consisting of normal c ervical epithelium (n = 13), lesions with histological features of HPV infe ction (n = 14), CIN (cervical intraepithelial neoplasia) lesions (n = 63), and cervical carcinomas (n 81) were examined immunohistochemically in paraf fin sections. Results. Twenty-three specimens showed p53 expression [3/20 (15%) CIN III, 18/63 (29%) ISCC (invasive squamous cervical carcinoma), and 2/18 (11%) ade nocarcinomas] while 63 cases expressed the bcl-2 gene [10/13 (77%) normal, 0/14(0%) condylomas, 6/23 (26%) CIN I, 9/20 (45%) CIN II, 15/20 (75%) CIN I II, 18/63 (29%) ISCC, and 5/18 (28%) adenocarcinomas]. The expression of bc l-2 was found to increase in direct relation to the grade of CIN (P = 0.02) whereas such a trend was not observed for p53. p53 was not detected in nor mal or premalignant lesions (except 3 out of 20 cases of CIN III). There wa s no significant correlation between the expression of p53 and the histolog ical type of cervical carcinoma, even though expression of p53 was higher i n ISCC than in adenocarcinomas (29% vs 11%, respectively). In cervical canc er patients, expression of bcl-2 was correlated to a greater than 5-year su rvival (P < 0.01) while no prognostic significance of p53 expression was fo und. Conclusion. Evaluation of bcl-2 expression may provide additional and indep endent prognostic information for the clinical course of the disease and th erefore to be developed as a prognostic indicator for cervical cancer. (C) 2000 Academic Press.