Journal Article

Apoptosis and the expression of Bax and Bcl-2 in hyperplasia and adenocarcinoma of the uterine endometrium

Katsuji Kokawa, Toshihiko Shikone, Tsutomu Otani, Rika Nishiyama, Yuki Ishii, Shigetaka Yagi and Mareo Yamoto

in Human Reproduction

Published on behalf of European Society of Human Reproduction and Embryology

Volume 16, issue 10, pages 2211-2218
Published in print October 2001 | ISSN: 0268-1161
Published online October 2001 | e-ISSN: 1460-2350 | DOI:
Apoptosis and the expression of Bax and Bcl-2 in hyperplasia and adenocarcinoma of the uterine endometrium

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BACKGROUND: Apoptosis plays a crucial role in carcinogenesis in various tumours. This study was designed to investigate the occurrence of apoptosis and the expression of Bcl-2 and Bax proteins in endometrial tumours of corpus uteri. METHODS: Endometrial tissues were obtained from 20 patients with endometrioid adenocarcinoma, 16 patients with endometrial hyperplasia, and 4 patients with myoma uteri (which were used as controls). The occurrence of apoptosis was examined by using molecular biochemical techniques. The expression of Bcl-2 and Bax proteins was also investigated using immunohistochemical staining with appropriate antibodies. RESULTS: The labelling of DNA in situ indicated that apoptotic cells were sporadically seen in postmenopausal endometrium (5.2 ± 2.1, n = 4) and endometrial hyperplasia without atypia (2.6 ± 0.5, n = 9). In contrast, labelled cells were detected in atypical endometrial hyperplasia (15.9 ± 2.2, n = 7), and their numbers increased intensely in adenocarcinoma (29.3 ± 3.7, n = 20). Autoradiographic analysis revealed DNA laddering in many cases of carcinoma. Bcl-2 was highly immunopositive in hyperplasia without atypia (36.2 ± 6.5%, n = 9), but was decreased in the atypical endometrial hyperplasia (16.3 ± 4.8%, n = 7). Large fractions of the carcinoma (6.3 ± 1.8%, n = 20) and normal endometrium (2.8 ± 1.4%, n = 4) were immunonegative or slightly immunopositive to Bcl-2. In contrast, Bax immunoreactivity was more frequent and stronger in adenocarcinoma (43.6 ± 4.1%, n = 20) than that in normal endometrium (17.6 ± 6.7%, n = 4) and hyperplasia (7.2 ± 2.2%, n = 16). CONCLUSIONS: These results suggest that cells in hyperplasia expressing Bcl-2 might have prolonged survival ability. Neoplastic cells in adenocarcinoma might show apoptosis in association with a decreased expression of Bcl-2 and an increased expression of Bax. Therefore, the frequency of apoptosis and the expression of Bcl-2 and Bax might be correlated with carcinogenesis in the uterine endometrium of humans.

Keywords: Apoptosis; Bax; Bcl-2; endometrial carcinoma; endometrial hyperplasia

Journal Article.  4336 words.  Illustrated.

Subjects: Reproductive Medicine

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