Ki67 and Bcl-2 immunoexpression in primitive urothelial bladder carcinoma

Vol. 53 No. 3 Suppl., 2012
This supplement was not sponsored by Outside Organizations.


M. Enache, Cristiana Simionescu, Luana Corina Lascu

Bladder cancer ranks among eight human malignant lesions, 90% being urothelial carcinomas. We evaluated the Ki67 and Bcl-2 immunoexpression and their correlations with clinicopathological parameters. The study included 45 primitive bladder urothelial carcinoma diagnosed in patients aged in VI and VII decades of life, predominantly in males. Histopathologically, the most numerous were moderately differentiated carcinomas (68.8%), most patients being classified in stage I of disease (48.8%). The analysis for Ki67 immunostain revealed positivity in 71.1% of cases, with higher values in moderate and poorly differentiated tumors in stage III or IV of disease. In contrast, immunoreactivity for Bcl-2 was present in 33.3% of well and moderately differentiated analyzed tumors and classified in stage I and II of disease. Tumor stage and grade is not correlated with Bcl-2 but there was a strong correlation with Ki67 proliferation index. Ki67 immunoexpression may be helpful to identify patients at high risk who may benefit by adjuvant therapies.

Corresponding author: Cristiana Simionescu, Professor, MD, PhD; e-mail:

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Anca Daniela Braila, Diana Vaniova Klimentova, C. M. Damian, M. B. Braila

Hysteroscopy and uterine curettage are required in cases of atypical hyperplasia in premenopause and in all cases of hyperplasia with/without atypia in postmenopausal women. Biopsic curettage is the method of choice in the diagnosis of endometrial pathology. Transvaginal ultrasound and Doppler examination are useful in assessing the risk of endometrial hyperplasia or endometrial cancer in postmenopausal women without/with continuous replacement therapy, but cannot replace endometrial biopsy to exclude endometrial cancer diagnosis. Medical treatment with progesterone containing drugs addresses endometrial hyperplasia without atypia. Surgical treatment is recommended for premenopausal and postmenopausal patients with uterine fibromatosis associated with atypical hyperplasia as well as patients with adenocarcinoma. Risk of progression to malignancy requires clinical and histopathological monitoring to avoid insufficient treatment of lesions with evolutive risk and aggressive treatment of lesions without risk.

Corresponding author: Anca Daniela Braila, Teaching Assistant, MD; e-mail:

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