Background: DCIS is a malignant proliferation of mammary ductal epithelial cells without invasion beyond the basementmembrane. Bcl-2, bax, bel-xiand p53areimplicatedin regulation of apoptosis. This study aimed to clarify the role of these gene products in DCIC.
Patients and methods: Immunohistochemical staining of 13 cases of DCIS with bcl-2, bax, bel-xi and p53 was performed.
Results: DCIS was graded into; 42% of low, 16% of intermediate, and 42% of high grade cases. P53 was negative in all low grades, positive in 66.7% intermediate grade, and in all high grade DCIS. Bcl-2 was positive in all DCIS with variable intensities. Bax was positive in 80% of low grade, 100% of intermediate grade, and in 100% of high grade DCIS. Bel-xi was positive in 80% of low grade, and in all intermediate and high grade DCIS. P53 was inversely correlated with bcl-2 expression in DCIS (p < 0.02). Insignificant positive correlation was present between p53 and bax expression and between p53 and bel-xi expression in DCIS. An inverse correlation was present between bcl-2 and bel-xi expression and between bcl-2 and bax expression in DCIS (p < 0.01 for each). Positive correlation was present between bax and bel-xi expression (p < O.000) in DCIS.
Conclusions: p53 mutation is an early event in the evolution of breast cancer and its expression correlates with high grade lesions. Strong positive correlation between bax and bel-xi, but the prognostic value of bcl-2 protein family in DCIC is still in need to more studies to be clarified.
Key words: Ductal carcinoma in situ, bcl-2 bax, bel-xi and p53.
Abbreviations: Ductal carcinoma in situ (DCIS), carcinoma in situ (CIS), invasive carcinoma (IC), inhibitor of apoptosis proteins (lAP), Hematoxylin and Eosin (H&E), catalogue number (Cat#), phosphate buffered solution (PBS), staining intensity (Sf), immunohistochemical scores
(IHCS), percentage of positive cells (PP), atypical ductal hyperplasia (ADH).