BCL-2 Protein Expression in Epithelial Ovarian Cancer: Association with Age and Histopathological Features in Uganda

Background: Globally, ovarian cancer accounted for 314,000 new cases and 207,000 deaths in 2020. In Uganda, 626 cases were documented over 25 years, with an average incidence rate of 7.1 per 100,000 women. Epithelial ovarian carcinoma is the predominant subtype, and BCL-2, a 26-kDa anti-apoptotic protein, has been associated with chemotherapy resistance. However, no study has assessed BCL-2 expression in epithelial ovarian cancer in Uganda. Objective: This study aimed to determine the prevalence of BCL-2 protein expression in epithelial ovarian cancer and its association with age and histopathological features in Uganda. Methods: A retrospective cross-sectional study was conducted using randomly sampled archived tissue blocks from 113 patients diagnosed with epithelial ovarian cancer. Samples underwent hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining to evaluate BCL-2 expression. Results: The mean patient age was 55 years, with the largest proportion (36.3%) aged 50–59 years. BCL-2 expression was observed in 36.3% of cases. There was no statistically significant association between BCL-2 expression and age (p = 0.396), histological subtype (p = 0.520), or tumor grade (p = 0.833). High-grade serous carcinoma was the predominant histological subtype (46%), and well-differentiated carcinoma was the most common grade (53%). Conclusion: BCL-2 expression was prevalent in epithelial ovarian cancer in Uganda but showed no significant association with age, histological grade, or subtype. These findings underscored the need for further research to explore the prognostic and therapeutic implications of BCL-2 in ovarian cancer management.