Immunohistochemical Study of BCL2 Protein, Oestrogen Receptor Alpha and Oestrogen Receptor Beta Expression in Adenocarcinoma Prostate and Benign Prostatic Hyperplasia

BACKGROUND Oestrogens are involved in the prostate carcinogenesis and neoplastic progression. Overproduction of B-Cell Lymphoma-2 Gene (BCL2) protein contributes to inhibition of apoptosis, prolongation of cell cycle and neoplastic expansion. In this study, the investigator has tried to characterize the expression of BCL2 in benign prostatic hyperplasia (BPH) and adenocarcinoma prostate and tried to assess the role of BCL2 as a prognostic factor in carcinoma prostate by comparing with Gleason score. Another objective was to study the oestrogen receptor alpha and beta expression in adenocarcinoma prostate. METHODS In this retrospective study, immunostaining of BCL2 is done in carcinoma prostate and BPH and compared with Gleason score. Immunohistochemical staining of oestrogen receptor alpha (ER alpha) and oestrogen receptor beta (ER 13) were studied in stromal and epithelial cells of carcinoma prostate and BPH. RESULTS A total of 35 cases of adenocarcinoma and 35 cases of BPH was studied. 13 high grade adenocarcinoma and 2 intermediate carcinoma and 10 cases of BPH showed BCL-2 positivity. ER 13 was present in epithelium in all cases and in stroma of 15 cases of carcinoma. In BPH, ER 13 was present in the epithelium of 21 cases and in stroma of 8 cases. ER alpha was present in epithelium in 3 cases and in stroma of 10 cases of carcinoma. In BPH, ER alpha is present in the epithelium of 21 cases and in stroma of 8 cases. CONCLUSIONS All prostatic carcinoma with a high Gleason grade showed BCL-2 positivity. This suggests that BCL-2 positivity in prostatic carcinoma may be considered as a prognostic marker. The ER 13 expression in epithelium of prostate carcinoma is much higher compared to BPH with a significant P value < 0.01. This reveals the role of ER 13 expression in proliferating and neoplastic prostate.