Immunohistochemical Expression of Bcl-2 and Ki-67 in Non-neoplastic and Neoplastic Endometrial Lesions- A cross-sectional study

Introduction Dynamic morphological changes occur in the female endometrium during the menstrual cycle. To keep tissue homeostasis, there should be a balance between apoptotic and mitotic activity in the normal menstrual cycle. Ki-67 is a known marker of cell mitotic activity, while Bcl-2 is an anti-apoptotic gene that controls apoptosis. When an imbalance in expression occurs, it is indicative of tumorigenesis. This study was conducted with an aim to correlate the immunohistochemical expression of Bcl-2 and Ki-67 in non-neoplastic and neoplastic endometrial lesions with histomorphological features. Objectives: The objective of the study was to classify non-neoplastic and neoplastic endometrial lesions on the basis of histomorphology and to correlate Bcl-2 and Ki-67 expression in non-neoplastic and neoplastic endometrial lesions. Methodology: A cross-sectional study was carried out in a tertiary center, Bareilly, UP, for one year, which included 60 histopathologically confirmed cases of non-neoplastic and neoplastic endometrial lesions. A tissue microarray was prepared. Further, immunohistochemistry was then applied as per standard protocol. Calculations were made regarding staining percentage and intensity. Results: In non-neoplastic endometrial lesions, Ki-67 showed the highest mean score in proliferative endometrium (8.5). In neoplastic endometrial lesions, endometrial carcinoma (11.5) had a substantially higher Ki67 mean score than hyperplasia. In non-neoplastic endometrial lesions, Bcl2 showed a higher mean score in endometrial polyp (10), and in neoplastic endometrial lesions, nonatypical hyperplasia (11.4) had higher mean score and least in endometrial carcinoma (8). Conclusion: It has been discovered that Bcl-2 and Ki-67 are accurate indicators of disease progression and may provide a new indication for treatment and monitoring.