Prognostic significance of co-overexpression of bcl-2 and c-erbB-2/neu in uterine cervix carcinomas and premalignant lesions.

Aim: To establish the role of co-overexpression of bcl-2 and cerbB- 2/neu protooncogenes in uterine cervix carcinogenesis, we examined 138 tissue samples of low grade cervical squamous intraepithelial lesions (SIL), high grade SIL, cervical carcinoma in situ and cervical invasive carcinoma, stage IA-IIA (study group) and 36 samples without SIL or malignancy (control group).

Methods: The expression of bcl-2 and c-erbB-2/neu was detected immunohistochemically using a monoclonal antibody. Fisher's exact test (p less than 0.05) was used to assess statistical significance.

Results: Co-overexpression of Bcl-2 and c-erbB-2/neu was found to increase in direct relation to the grade of the squamose intraepitelial lesions (SIL) of cervix. Statistically significant difference was found in the frequency of co-overexpression in patients with high grade SIL (12/22, p=0.006), cervical carcinoma in situ (10/22, p=0.018) and cervical invasive carcinoma (12/26, p=0.012), in relation to the control group. High sensitivity was of great diagnostic significance for the detection of these types of changes in the uterine cervix.

Conclusion: On the basis of high predictive values it can be said that in patients with co-overexpression of bcl-2 and c-erbB-2/neu overexpression there is a great possibility that they have premalignant or malignant changes in the uterine cervix. However, a more extensive series of samples and additional tests are required to establish the prognostic significance of these oncogenes in cervical carcinogenesis.