Background: To investigate the morphologic and immunohistochemical spectrum of expression of anti-apoptotic BAG-1 protein in a cohort of patients with dysplasia of low-grade squamous intraepithelial lesions (LSILs) and highgrade squamous intraepithelial lesions (HSILs) and invasive squamous cell carcinomas (SCCs) of the uterine cervix. Methods: A total 92 consecutive cervical tissues were examined. Sixty-two were found to be non-keratinized large cell SCCs (included 6 SCCs with lymph node metastases and 6 keratinized SCCs), 30 were SILs (10 LSILs and 20 HSILs), and 10 were normal cervical tissues. The expression of BAG-1 was determined by immunohistochemical assay using polyclonal antibody recognizing BAG-1 biomarker. Results: In the normal cervical tissue, BAG-1 expression showed nuclear staining in the basal and parabasal layers. In LSILs, HSILs and SCCs, BAG-1 demonstrated remarkable nuclear or mixed with light intracytoplasmic staining in the mild to severe dysplastic and malignant epithelium. The prevalence were 50% (5/10), 60% (12/20), 84% (42/50) for the LSILs, HSILs and SCCs, respectively. In the SCCs, BAG-1 expression illustrated a tendency for mildly reduced nuclear staining intensity and showed significant differences between SILs and normal tissues (p<0.05). Furthermore, in lymph node metastases, nuclear BAG-1 staining revealed mild decreases in 4 of 6 cases when compared with corresponding primary tumors. However, no significant associations were found between the cell differentiation/keratinization and lymph node metastatic status (p>0.05). Conclusions: BAG-1 overexpression and the distinct subcellular distribution may contribute to its more aggressive behavior and involvement in cervical carcinogenesis. Thus, BAG-1 overexpression may serve as a novel diagnostic molecular biomarker in the diagnosis of cervical carcinoma.
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