Relationship between cell proliferation and apoptosis with bcl-2,p53,proliferating cell nuclear antigen expression in renal cell carcinoma

Objective To investigate the relaitonship between the immunohistochemical expression of bcl-2,p53,and proliferating cell nuclear antigen (PCNA) with cell propiferation,apoptosis in renal cell carcinoma (RCC).Methods Formalin-fixed and paraffin-embedded tissue blocks from 34 patients with RCC were studied.Immunoreactivity of bcl-2,p53 and PCNA were assessed immunohistochemically.Apoptosis was detected by terminal deoxy- nucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL).Results The expression of the bcl-2 protein was detected in 15 cases (44.1%),while that of the p53 protein was detectable in only 3 cases.bcl-2 positivity was not associated with any pathological parameters.The proliferative index (PI) ranged from 6.0% to 24.0% (mean 12.3%) and the apoptosis index (AI) from 2.0% to 8.0% (mean 5.4 %) in RCC.PI was closely associated with tumor grade and stage,and a significant relationship between AI and the tumor grade of RCC was seen.Conclusion Obviously increased PI and AI is correlated with the malignant phelotypes of tumors,suggesting active cell proliferation may be accompanied by frequent apoptosis in RCC.