BCL-2 EXPRESSION AS A PROGNOSTIC FACTOR OF SURVIVAL OF GASTRIC-CARCINOMA

Background: Although the bcl-2 proto-oncogene is important in determin ing tumor cell susceptibility to apoptosis, no data about the clinical importance in gastric cancer are available. Methods: We analyzed bcl- 2 and p53 expression, proliferative activity, and tumor apoptosis in l ocally advanced gastric carcinomas from 84 patients. Results: Immunohi stochemical analysis indicated that 41.7% and 48.8% of the tumors were bcl-2 and p53 protein positive, respectively. The apoptotic fraction was significantly lower in bcl-2-positive than negative tumors. Univar iate analysis indicated low apoptotic fraction was one of the poor pro gnostic factors. Multivariate analysis showed a trend toward improved survival in bcl-2-positive patients. In patients with lymph node metas tases more severe than group 2 lymph node, survival was significantly longer in those with bcl-2-positive tumors. Conclusions: The expressio n of bcl-2 and the high apoptotic fraction were concluded to be import ant prognostic factors of survival in patients with advanced gastric c ancer.