Markers of apoptosis in stage IB squamous cervical carcinoma

Abstract

Aims: To examine the prognostic relevance of the expression of the Bcl-2, Bcl-x L, and Bax proteins in stage IB squamous cervical carcinoma (SCC). Methods: In total, 220 patients who underwent radical hysterectomy and bilateral lymphadenectomy at the Norwegian Radium Hospital for stage IB SCC between 1987 and 1993 were studied. Immunohistochemistry using monoclonal antibodies against Bcl-2, Bcl-x L, and Bax was used to examine protein expression. Ten patients who underwent hysterectomy for uterine prolapse served as controls. Results: Cytoplasmic expression of Bcl-2, Bcl-x L, and Bax was low (< 5% positive cells) in 159 of 220 (73%), 193 of 220 (87%), and 39 of 220 (18%) tumours, respectively, and high (≥ 5% positive cells) in 61 of 220 (27%), 27 of 220 (13%), and 181 of 220 (82%) tumours, respectively. In univariate analysis, all classic clinicopathological parameters but none of the investigated proteins were associated with prognosis. In multivariate analysis, only deep stromal invasion was independently related to survival. Conclusion: Bcl-2, Bcl-x L, and Bax were not independently associated with prognosis in stage IB SCC.