Abstract

Endometrial cancer is one of the common gynecologic cancer and accounts for nearly 5% of cancer cases and more than 2% of deaths due to cancer in women worldwide.Bcl-2 is an anti-apoptotic gene involved in the regulation of apoptosis and Ki-67 is a recognized indicator of cell mitotic activity. Increased expression of both indicates tumorigenesis. Analyzing the expression of these markers in cyclical endometrium, endometrial hyperplasia and in endometrial carcinoma will help in the development of new treatment modalities specific against these markers. Aim and objectives: To evaluate the expression of Bcl-2 and Ki-67 in endometrial lesions and to compare the pattern of expression of Bcl-2 and Ki-67 in different endometrial lesions and in cyclical endometrium. Methods: Hospital based observational, cross- sectional study was conducted in 57 patient of different cyclical endometrium and endometrium lesions. The selected tissue blocks were processed for hematoxylin and eosin stain and IHC staining for Bcl-2 and Ki-67. Results: In this study, 11 cases of proliferative endometrium and 9 cases of secretory endometrium were studied. Mean Bcl-2 score was 7.6 in proliferative phase and 1.3 in secretory phase whereas mean Ki-67 score was 7.27 in proliferative phase and 2.4 in secretory phase. In this study 10 cases of Disordered proliferative phase showed mean score 11.2 of Bcl-2 that was slightly higher than hyperplasia which has Bcl-2 score of 6.2. Of the total 12 cases of hyperplasia 9 cases were of simple hyperplasia and 3 were of atypical hyperplasia. In simple hyperplasia mean score was 6.2 for Bcl2 and 4.8 for Ki-67. In atypical hyperplasia mean score was 4 for Bcl-2 and 2.6 for Ki- 67. Conclusions: Bcl-2 and Ki-67 have been found to be reliable markers to indicate the progression of the disease and might be a novel indication for treatment and follow-up.

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