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The prognostic value of spontaneous apoptosis, Bax, Bcl-2, and p53 in oral squamous cell carcinoma of the tongue

✍ Scribed by Xin Xie; Ole Petter F. Clausen; Paula De Angelis; Morten Boysen

Publisher: John Wiley and Sons
Year: 1999
Tongue: English
Weight: 112 KB
Volume: 86
Category: Article
ISSN: 0008-543X
DOI: 10.1002/(sici)1097-0142(19990915)86:6<913::aid-cncr4>3.0.co;2-a

No coin nor oath required. For personal study only.

✦ Synopsis

BACKGROUND. Bax, Bcl-2, and p53 proteins are involved in the regulation of apoptosis and have been reported to correlate with prognosis in several tumor types.

METHODS.

Bax, Bcl-2, p53, and the level of spontaneous apoptosis were evaluated in formalin fixed, paraffin embedded pretreatment specimens from 85 T1-4 squamous cell carcinomas (SCCs) of the tongue by immunohistochemical methods.

The percentage of apoptotic cells labeled by the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP labeling (TUNEL) method was expressed as an apoptotic index (AI). For Bax and Bcl-2 evaluation, the fraction of tumor cells stained and the staining intensities were given scores that were added together, resulting in a final score. p53 immunostaining was expressed as a percentage of positive cells.

RESULTS.

High AI was significantly associated with high Bax expression (P ϭ 0.0122) and highly differentiated tumors (P ϭ 0.0062). No correlation was found between AI and Bcl-2 expression. There was no correlation between p53 positivity and any of the other apoptosis-related parameters. Whereas low AI scores and low Bax expression correlated significantly with poor prognosis (P ϭ 0.0053 and P ϭ 0.0012, respectively), a low Bcl-2 expression was associated with a favorable clinical outcome (P ϭ 0.0262). Patients with a high Bcl-2/Bax expression ratio had a significantly poorer prognosis than those with a low ratio (P Ͻ 0.0001). Multivariate analysis revealed that Bax expression, the Bcl-2/Bax expression ratio, and the T and N classifications were significantly independent prognostic variables. The Bcl-2/ Bax expression ratio was the strongest independent prognostic parameter.

CONCLUSIONS. AI, individual

Bax and Bcl-2 expression, and particularly the Bcl-2/ Bax expression ratio have prognostic value in SCC of the tongue.

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