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Alterations of p53, Bcl-2, and hMSH2 protein expression in the cirrhotic, macroregenerative, dysplastic nodules and hepatocellular carcinomas in Upper Egypt


  • Former address: School of Medicine, University of Wisconsin, Madison, WI 53715,USA.

Mahmoud R. Hussein, Mscpath, MD, PhD, Department of Pathology, Faculty of Medicine, Assuit University, Assuit, Egypt.
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Abstract: Background: Hepatocarcinogenesis involves alterations in p53, Bcl-2 and human Mut S homologue-2 (hMSH2) genes. In Upper Egypt, the clinicopathologic and genetic changes during hepatocarcinogensis (cirrhotic nodules (CN); macroregenerative nodules (MRN) and dysplastic nodules (DN) are unknown.

Methods: To examine these issues, 48 hepatic resection specimens entailing 25 CN, 16 MRN, 23 DN and 48 hepatocellular carcinoma (HCC) were immunohistochemically evaluated for p53, Bcl-2 and hMSH2 protein expression.

Results: HCC was common in males than in females (2.6:1, P<0.05) and with hepatitis C virus than hepatitis B virus infection (77.1% vs. 18.7%, P=0.001). p53 expression was found in DN (3/23) and HCC (12/48). Its average weighted scores were high in DN/HCC as compared with CN (1.60±0.40 and 7.20±1.20, P=0.0001). Bcl-2 expression was seen in CN, MRN, DN and HCC (7/48). Its average weighted scores were high in DN (7.60±1.60), HCC (6.86±0.85) as compared with CN (6.14±0.42) and MRN (6.50±0.50, P=0.22). hMSH2 average weighted scores were reduced in HCC (7.94±1.06) as compared with CN (8.47±0.52), MRN (8.00±1.00) and DN (8.20±0.80, P>0.05).

Conclusion: In Upper Egypt: (1) HCC had similar clinicopathologic features to those in the high-risk regions, and (2) alterations of the p53, Bcl-2 and hMSH2 proteins occur during hepatocarcinogensis.