Sk. Kassim et al., Increased bcl-2 expression is associated with primary resistance to chemotherapy in human epithelial ovarian cancer, CLIN BIOCH, 32(5), 1999, pp. 333-338
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.