Prognostic significance of Bcl-2 expression and p53 nuclear accumulation in colorectal adenocarcinoma

✍ Scribed by Upender Manne; Russell B. Myers; Cecilia Moron; Robert B. Poczatek; Stephenie Dillard; Heidi Weiss; David Brown; Sudhir Srivastava; William E. Grizzle

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: French
• Weight: 214 KB
• Volume: 74
• Category: Article
• ISSN: 0020-7136
• DOI: 10.1002/(sici)1097-0215(19970620)74:3<346::aid-ijc19>3.0.co;2-9

✦ Synopsis

The products of bcl-2 and p53 genes are involved in the regulation of apoptosis and proliferation and have been associated with prognosis in several malignancies, including colorectal adenocarcinoma. Although 2 European studies have reported a prognostic significance of Bcl-2 expression in colorectal adenocarcinomas, a study from the United States did not observe such an association. Therefore, we used immunohistochemistry to evaluate the prognostic significance of Bcl-2 expression, p53 nuclear accumulation and their concomitant expression in 134 US patients with colorectal adenocarcinoma. Antigen retrieval was required for adequate detection of Bcl-2 expression. Fifty percent of the colorectal tumors were classified as expressing Bcl-2, and Bcl-2 expression was associated with longer patient survival. Antigen retrieval was not necessary for detecting nuclear accumulation of p53 by immunohistochemistry. Nuclear accumulation of p53 was detected in 44% of colorectal adenocarcinomas and was associated with decreased patient survival. Tumors that did not express detectable levels of Bcl-2 but exhibited nuclear accumulation of p53 were associated with the shortest patient survival (log rank, p 5 0.001). Multivariate Cox regression analysis demonstrated that Bcl-2 expression (p 5 0.018), p53 nuclear accumulation (p 5 0.024) and regional lymph-node metastasis (p 5 0.005) were independent prognostic factors. Although a trend toward an inverse correlation between Bcl-2 and p53 expression was observed, the prognostic value of Bcl-2 expression was independent of p53 status. Thus, assessment of both Bcl-2 and p53 status may be valuable in predicting the prognosis of patients with colorectal adenocarcinomas.