Increased bcl-2 expression is associated with primary resistance to chemotherapy in human epithelial ovarian cancer

Objective: bcl-2, an anti-apoptotic factor, has a role in the pathogenesis of ovarian cancer as well as in resistance to chemotherapy. Design and Methods: 20 benign, and 26 malignant epithelial ovarian tissues were analyzed for bcl-2 protein and mutant p53 by enzyme-immunoassay (EIA). Flowcytometric analysis was also per formed. Patients of malignant group w ere followed up to monitor overall survival and primary resistance to chemo therapy. Results: bcl-2 was significantly higher in malignant group than benign grou p (p < 0.001). A cutoff value was determined for bcl-2 (63.8 kU/g protein). At this cutoff, sensitivity is 80.7%, and specificity is 85%. Using chi sq uare analysis, a significant correlation was found between bcl-2 and FIGO s tage (p = 0.01), overall survival (p = 0.01), as well as primary resistance to chemotherapy (p = 0.03). By correlation coefficient analysis the relati on between bcl-2 and synthetic phase fraction was highly significant (p = 0 .002). Bcl-2, p53, and FIGO stage were significantly correlated to poor sur vival (p = 0.01) in univariate analysis. However, in multivariate analysis, only FIGO stage, and p53 were independent risk factors. Conclusion: EIA could be a useful tool for investigating the prognostic val ue of bcl-2, and its possible prediction of platinum resistance in epitheli al ovarian cancer. This might help in selecting patients for future anti-bc l-2 therapy. Copyright (C) 1999 The Canadian Society of Clinical Chemists.