Prognostic factors in resectable pancreatic cancer: p53 and Bcl-2

The p53 tumor suppressor gene and the Bd-2 proto-oncogene regulate cell cyc le progression and apoptosis. We evaluated the expression of these molecula r markers with standard pathologic prognostic variables in patients who rec eived multimodality therapy for resectable adenocarcinoma of the pancreas t o study the effect of p53 and Bcl-2 on survival duration. Immunohistochemic al staining of archival material was performed to determine levels of expre ssion of p53 and Bcl-2 proteins in 70 patients with adenocarcinoma of pancr eatic origin, All patients underwent a potentially curative pancreaticoduod enectomy and standardized pathologic analysis of resected specimens. Potent ial pathologic and molecular prognostic variables were assessed for their e ffect on survival duration. Nuclear staining for p53 was observed in 33 (47 %) of 70 specimens. Immunostaining for Bcl-2 was observed in 23 specimens ( 33%). A trend toward improved survival duration was seen in patients whose tumors stained positive for either pi? or Bcl-2. Negative staining for both markers predicted short survival (P = 0.01). By univariate and multi varia te analyses, no single pathologic factor was associated with survival durat ion. Immunohistochemical staging using both p53 and Bcl-2 significantly pre dicted survival duration by univariate and multivariate analysis; patients whose tumors stained positively for p53 and/or overexpressed Bcl-2 had a si gnificantly longer survival than those whose tumors stained negative for bo th proteins.