Analysis of BCL-2 protein expression in keratinocytic hyperproliferative lesions

Abstract

Apoptosis regulates keratinocytic proliferation and formation of stra-tum corneum in skin and is regulated by proteins like BCL-2 which con-trols cell survival and p53 which regulates cell death. Dysfunctional apoptosis plays an important role in development of hyperproliferative skin disorders including non-tumorigenic, pre-tumorigenic and tumor-igenic conditions. Therefore, we conducted a study to analyze the ex-pression pattern of apoptosis regulating protein BCL-2 in keratinocytic hyperproliferative lesions. The aim of this study was to evaluate and compare BCL-2 expression in various non-tumorigenic, pre-tumorigenic and tumorigenic keratinocytic hyperproliferative lesions. Skin biopsies of hyperproliferative keratinocytic lesions were studied from October 2018 to September 2020. The cases were categorized into 3 groups based on histological diagnosis (non-tumorigenic, pre-tumorigenic and tumorigenic). Following this, IHC for BCL-2 was performed on all cases using standard protocol. Tumorigenic lesions included 7 cases of SCC, pre-tumorigenic included 6 cases of seboherric keratosis, 2 cas-es of condyloma acuminata, 1 case of epidermodysplasia verruciform-is and 1 case of actinic keratosis, while the remaining 35 cases were non-tumorigenic, including psoriasis (6 cases), verruca vulgaris (4 cas-es), lichen planus (12 cases), chronic dermatitis (9 cases) and lichen simplex chronicus (4 cases). BCL-2 average weighted score in non-tumorigenic lesions was (1.25±1.13) as compared with pre-tumorigenic and tumorigenic lesions (5.30±3.32) and thus showing a significant p value (p<0.001). To conclude, significantly increased BCL-2 expression in neoplastic lesions shows that increased cell survival may contribute to neoplastic transformation.