Rising of the incidence rate of testicular germ cell tumors in combination with the predominantly young age of patients gives this problem medical and social significance. The purpose of the work was to establish proliferative and apoptotic processes in testicular embryonal carcinoma. Material and methods. The study was performed on 13 surgically removed testicles affected by embryonal carcinoma. Tumors were grouped according to the degree of tumorous progression in accordance with the pTNM classification. For evaluation of proliferative and apoptotic processes the relative area (S) and intensity (L) of Ki–67, Bax, Bcl–2, and p53 expression were studied. The proliferation index was calculated as well. Results and discussion. The study determined increasing of average S, L values of Ki–67 expression and proliferation index. We also revealed very high and high positive correlation between proliferation index and S with L of Ki–67 expression (r=+0.94; r=+0.83; p<0.05, respectively) during the transition from the initial to the late stages of tumorous progression. S of Bax expression was also increasing at the transition from early to late stages of tumorous progression, and L expression remained low regardless of stage. High positive correlation between S of Bax and S of Ki–67 expression and between S of Bax and proliferation index (r=+0.84; r=+0.82; p<0.05, respectively) was revealed during the transition from the initial to the late stages of tumorous progression. In patients with distant metastases and metastases to the lymph nodes S of Bax expression was bigger than that in patients without metastases. The activity of anti–apoptotic protein bcl–2 in the embryonal carcinoma was insignificant and determined predominantly in the cells of immune infiltrate. A very high and high negative correlation was found between S of bcl–2 expression and S of Ki–67 expression with proliferation index (r= –0.92; r=–0.88; p<0.05, respectively) during the transition from the initial to the late stages of tumorous progression. Correlation analysis revealed a high positive relationship between S of p53 expression and S of Bax and Ki–67 expression (r=+0.82; r=+0.71; p<0.05, respectively) during the tumorous progression and a moderate positive relationship between S of p53 expression and proliferation index (r=+0.69; p<0.05). In patients with lymphogenic metastases S of p–53 expression was bigger than that in patients without metastases (p<0.05). Conclusion. Thus, the use of Ki–67, Bax, bcl–2, and p53 markers in the diagnosis of testicular tumors is advisable, since they reflect the malignant potential of the tumor, and can be used as prognostic markers.
Keywords: embryonal carcinoma, proliferation, apoptosis, immunohistochemistry
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