Spontaneous apoptosis in advanced esophageal carcinoma: Its relation to Fas expression

The prognostic Importance of spontaneous apoptosis and its correlation with clinicopathological characteristics and Fas expression have yet to be deli neated in esophageal carcinoma. Specimens from 65 patients with advanced sq uamous cell carcinoma of the esophagus were used for immunohistochemical ev aluation of Fas, proliferating cell nuclear antigen, and apoptosis, The mea n apoptotic index (AI) of 65 tumors was 1.38 +/- 0.99% (range, 0.10-4.49%). Thirty-nine (60.0%) patients had a high AI, and 26 (40.0%) patients had a low Al, Low Al was correlated with advanced tumor stage (P = 0.0197) and we ak Fas expression (P = 0.0093). Patients with a low Al had significantly (P = 0.0095) worse survival than those with a high Al, However, by multivaria te analysis, low Al alone was not an independent prognosticator, When combi ned with cellular proliferation index, AI became an independent prognostic factor (P = 0.0283) in this group of patients. Our results suggest that enh anced Pas expression Is responsible for high AI in squamous cell carcinoma of the esophagus, High Al, combined with the cellular proliferation labelin g index, could be an independent prognostic indicator.