Bcl-2 antigen expression in patients with chronic hepatitis C and advanced fibrosis

Bcl-2 antigen is a proto-oncogene responsible for the inhibition of the death of cells in the mechanism of apoptosis. The expression of bcl-2 antigen was analysed in liver bioptates obtained from patients with chronic hepatitis C. Thirty-five patients with advanced fibrosis (bridging fibrosis or cirrhosis) and various inflammatory activity were investigated. Control group was formed of the subjects with minimum or non-existent fibrosis. Histological and immunohistochemical assessments were performed with the use of widely-acceptable methods. The expression of bcl-2 antigen within portal spaces and lobules was evaluated. The values of lobular index declined as the fibrosis increased. As far as portal space index is concerned, no significant changes in correlation with fibrosis advancement were noticed. Additionally, the expression of bcl-2 antigen was recorded within lymphocyte infiltrations in lobules and portal spaces, in the epithelium of bile ducts in portal spaces and proliferating bile ductules in lobules as well as in perisinusoid cells. In hepatocytes, bcl-2 expression was detected more often among controls than in the analysed patients. The expression of bcl-2 antigen is directly proportional to the degree of inflammatory activity and it is inversely proportional to the degree of fibrosis. It seems that positive colour reaction with bcl-2 antigen in lobules may be of prognostic value for the prediction of collagen fibroplasia development. Bcl-2 expression in portal spaces has a limited diagnostic value for the prediction of the scope of fibrosis in patients with chronic hepatitis C.