## 4 Discussion  
To the best of our knowledge, the prognostic role of PTEN protein expression through immunohistochemistry has not been evaluated in patients with cervix cancer earlier on Sudanese's patients. In the present study, it was perceived that PTEN protein expression was high in inflammatory lesions and loss of PTEN protein expression was noted in cervical cancer tissue samples, and such difference was significantly significant (\(p<0.05\)). An earlier finding based on Chinese patients was in accordance with this finding and results showed that PTEN expression progressively decreased with the normal epithelium of the tissue to squamous cell carcinoma of the cervix [27]. Another recent study from other part of world reported that nuclear PTEN expression was detected in all cervicitis cases whereas 63/102 (62%) cases of cervical cancer showed PTEN expression [28]. Moreover, the current study showed that loss of PTEN expression was significantly associated with clinical stage of the SCC of the uterine cervix (61.36 and 45.16% in stages I-II and III-IV, respectively) (\(p<0.05\)). No associations were found between the PTEN expression and grade of differentiation and age of the patients (\(p>0.05\)). In this regards, a previous finding also reported that PTEN protein expression was significantly correlated with the stage of the cervical SCC and lymph node metastasis [28] and positive PTEN immunostaining was associated with clinical stage and tumor size [27]. The _Bel2_ gene belongs to the anti-apoptotic genes in the _Bel2_ gene family, and its altered expression has been noticed in several types of tumors including carcinoma of the cervix. In the current study, it was reported that cytoplasmic expressions of Bcl2 protein were noted in 60% (45/75) cases of cervical cancer tissue. The expression pattern of Bcl2 was high in cancer cases than in control cases, and such a difference was statically significant (\(p<0.05\)). There are scanty of data available on the expression of Bcl2 protein in cancer based on Sudanese patients. Previous study based on the oral cancer sample of Sudan revealed that expression of Bcl2 was found to be restricted to tumor cells in well and moderately differentiated tumors. There is no expression or undetectable expression of Bcl2 in basal cells [29]. The current findings are in keeping with an earlier study on cervical cancer from China, which reported that Bcl2 in the tissue of cervical cancer was significantly higher than that in normal cervical tissue [30]. Moreover, Bcl2 did not show any significant association with the histologic type (\(p>0.05\)), the age of the patients and clinical stage of the cervical SCC (\(p>0.05\)). These findings are similar to a previous result on cervical cancer, which reported that expression of Bcl2 had no significant association with the histologic type or clinical stage [31]. Another study said that Bcl2 was expressed in 65% of the tumors and there was a statistically significant association between Bcl2 expression and poorer disease-free survival (DFS) and overall survival (OS) in stage IIB cases [32]. \begin{table}
\begin{tabular}{c c c c c} \hline \hline
**Variables** & **Total Cases** & **p53 Positive** & **p53 Negative** & \(p\)**-Value** \\ \hline Cervical carcinoma & 75 & 43 (57.33\%) & 22 (29.33\%) & \\ \hline Inflammatory lesion & 10 & 00 (00\%) & 10 (100\%) & \\ \hline Age (In years) & 31 & 17 (54.83\%) & 14 (45.16\%) & \\ \(\leq\)58 years & 44 & 26 (59.09\%) & 18 (40.90\%) & \\ \hline Histological grades & & & \\ \hline Well differentiated & 24 & 15 (62.5\%) & 09 (37.5\%) & \\ \hline Moderately differentiated & 34 & 20 (58.82\%) & 13 (38.2\%) & \\ \hline Poorly differentiated & 17 & 08 (47.05\%) & 08 (47.05\%) & \\ \hline Clinical stage & & & \\ \hline I and II & 44 & 25 (56.81\%) & 16 (36.36\%) & \textgreater{}0.05 \\ \hline III and IV & 31 & 18 (58.06) & 14 (45.16\%) & \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Correlation between p53 expression and clinico-pathological features of cervical SCC.