Bcl-2 DAN INDEKS APOPTOSIS PADA HIPERPLASIA ENDOMETRIUM NON-ATIPIK SIMPLEKS DAN KOMPLEKS

Abstract

Background : Apoptosis controls cell hemostasis in the endometrium during normal menstrual cycles, and morphologic studies have suggested its association with the pathology of endometrium. Apoptosis is regulated by several genes, especially those of the Bcl-2 family, but their significance in endometrium pathologies is not well understood. Objective : To assess the difference and correlation of Bcl-2 expression and apoptotic index in simple and complex non-atypical endometrial hyperplasia Design : Paraffin-embedded non-atypical endometrial hyperplasia tissues composed of each 28 cases simple and complex endometrial hyperplasia. Expression of Bcl-2 was examined by immunohistochemistry for calculation persentage of stained cells and intensity of the staining. Apoptotic activity was assesed using the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) assay and apoptotic index was determined. Result : The patient’s characeristics were the same between two groups. There was no difference of intensily positive intensity of the staining in endometrial gland epithelial of simple and complex hyperplasia. Expression of Bcl-2 in complex endometrial hyperplasia was higher than simple (p=0.013). Within cut off point 0.92 of Bcl-2 expression, the endometrium with Bcl-2 0.92 had a risk 2.6 times to be a complex hyperplasia. Apoptotic index in simple endometrial hyperplasia was greater than in complex (p=0.014). Apoptotic index with cut off point 9 was explained that apoptotic index 9 had a risk to be a simple hyperplasia 3.8 times. Simple hyperplasia had a strongly negative correlation (r=-0.756; p=0.000) between expression of Bcl-2 and apoptotic index and there was not found a negative correlation in complex cases (r=-0.257; p=0.94). Conclusion : Expression of Bcl-2 in complex non-atipycal endometrial hyperplasia has been greater than in simple and apoptotic index is lower in complex than in simple. Negative correlation between expression of Bcl-2 and apoptotic index is only found in simple non-atypical endometrial hyperplasia. Keyword : Bcl-2, apoptotic index, simple and complex non-atypical endometrial hyperplasia