Bcl-2: Bax and bcl-2: Bcl-x ratios by image cytometric quantitation of immunohistochemical expression in ovarian carcinoma: Correlation with prognosis

Bcl-2 is a proto-oncogene which is involved in prolonging cell survival by inhibiting programmed cell death, Bar and bcl-x are members of the bcl-2 fa mily; when overexpressed, they can counteract the ability of bcl-2 to inhib it apoptosis. This suggests a model in which the ratios of bcl-2 to bar and bcl-x can be used to determine response to therapy and prognosis. The expr ession of bcl-2, bar and bcl-x was studied in 50 ovarian carcinomas. The pe rcentage of positive area immunostained (PPA) in the nucleus and cytoplasm of each ovarian carcinoma was quantitated in 15 high power fields by image cytometry, The ratios were obtained by dividing the PPA of bcl-2 by the PPA of bar and bcl-x, 17 of 50 ovarian carcinomas (34%) stained positively for bcl-2, 39 for bar (78%) and 47 for bcl-x (94%), Although there is no signi ficant statistical correlation between expression of bcl-2, bar or bcl-x an d grade (P = 0.15; P = 0.47; P = 0.56), stage (P = 0.71; P = 0.6; P = 0.42) , and overall or disease-free survival (P = 0.26; P = 0.55; P = 0.16), incr eased bcl-2 expression was demonstrated in patients with shortened overall and disease-free survival, Also, increased expression of bar and bcl-x was associated with increased overall and disease-free survival, Bcl-2:bax and bcl-2:bcl-x ratios less than 1 are associated with survival advantage, alth ough not statistically significant (P = 0.83; P = 0.93), Image cytometric m easurement of bcl-2, bar, and bcl-x expression is feasible, There is a tend ency for their expression to correlate with prognosis in ovarian carcinomas , (C) 2000 Wiley-Liss, Inc.