Immunohistochemical analysis of Bcl-2 protein in early squamous cell carcinoma of the bronchus treated with photodynamic therapy

Photodynamic therapy (PDT) in early squamous cell carcinoma of the bronchus has been shown to result in complete response (CR) and cure. However, loca l recurrence after PDT develops frequently even after complete remission. B ecause the effect of PDT had been reported to depend on apoptosis, and apop tosis is inhibited by bcl-2 protein, the relationship between the expressio n of bcl-2 protein and local recurrence after PDT was examined immunohistoc hemically. From 1983 to 1997, 50 patients with 59 early squamous cell carci noma of the bronchus received PDT, and a CR was obtained in 43 lesions (72. 8%). AS there was no recurrence among tumours that were disease-free for mo re than 2 years, in this study the tumours were defined as cured when recur rence did not occur 2 years subsequent to the receiving of PDT. Of these CR lesions, 31 carcinomas (53.4%) resulted in a cure. Bcl-2 immunoreactivity was detected in 23 tumours (46.9%) and p53 immunoreactivity was detected in 22 tumours (44.9%), When all tumours were divided into either a large tumo ur with a longitudinal tumour length of 10 mm or more, or a small tumour wi th a length of less than 10 mm, the large tumour expressed more bcl-2 prote in than the small tumour (P = 0.0155). The degree of bcl-2 expression was s ignificantly related with tumour size (P = 0.0155), The expression of bcl-2 and p53 protein was not associated with the cure rate due to PDT. Tumour l ength and T status in TNM staging were significantly related to the cure by univariate analysis. T status was the only predictor of the cure according to multivariate analysis. Of 42 CR lesions, the expression of neither bcl- 2 nor p53 protein was associated with local recurrence; only T status was s ignificantly associated (P = 0.008). The relationship between the expressio n of oncoprotein and local recurrence after PDT was not documented in this study. The success of PDT may depend on the exact assessment of tumour size under optimized PDT illumination. (C) 2000 Cancer Research Campaign.