To clarify kinetics in
ulcerative colitis (UC)-associated lesions, cell proliferation, apoptosis, and expression of apoptosis-inhibitory
proteins were studied. Ki-67 labeling and
survivin and bcl-2 expression were examined immunohistochemically in 22 low-grade dysplasias (LGDs), 25 high-grade dysplasias (HGDs), and 13
adenocarcinomas associated with UC, and for comparison in 21 sporadic
adenomas with LGD, 22 sporadic
adenomas with HGD, and 21 invasive
adenocarcinomas. Apoptosis was studied with nick-end labeling and immunohistochemical analysis of
single-stranded DNA. In UC-associated LGDs, Ki-67--positive cells were more frequent in the lower than the upper half of the crypt, related to bcl-2 expression, while in sporadic
adenomas such cells were more common in the upper half. No difference in apoptosis was found between UC-associated LGDs and sporadic
adenomas with LGD or between UC-associated HGDs and sporadic
adenomas with HGD. However, UC-associated
carcinomas exhibited a lower apoptotic count than their sporadic invasive counterparts. This seemed related to higher
survivin expression without a significant difference between the 2 types of invasive lesions regarding bcl-2 levels. Apoptosis is less frequent in UC-associated than in sporadic invasive colon
carcinomas, this being linked to elevated
survivin expression. The control of apoptosis may be different in the 2 types of
tumorigenesis.