Expression of BCL-2 in endometrial hyperplasia

Abstract

Background: The specific patterns of BCL-2 expression in different stages of endometrial cycling and pathological conditions of the endometrium remain unclear.

Objectives: To analyse the expression of BCL-2 oncoprotein in cyclical endometrium, endometrial hyperplasia, and endometrial carcinoma. Methods: This was a prospective study conducted in the Department of Pathology, Santhiram Medical College and General Hospital, Nandyal, Andhra Pradesh between December 2017 and November 2019. The study included 682 endometrial specimens.

Results: There were 552 cases (80.93%) of cyclical endometrium, of which 55.71% were in proliferative phase and 25.21% were in the secretory phase. The remaining specimens were with hyperplasia without atypia (13.63%), atypical hyperplasia (4.69%), and endometrial carcinoma (0.73%). Out of 682 cases, 3.22% were nulliparous, 48.24% were primipara, and 48.53% were multiparous; 10.55% had attained menopause, and 89.45% did not attain menopause. BCL-2 expression in proliferative phase was graded as 3+, in hyperplasia without atypia as 2+, atypical hyperplasia, and endometrial carcinoma as 1+. The intensity of the staining was gradually decreased from the proliferative phase to endometrial carcinoma.

Conclusion: BCL-2 can be used as an independent prognostic marker in routine. It can be an inexpensive histopathological marker useful to identify and follow up the patients with atypical hyperplasia who may progress to endometrial adenocarcinoma.