U. Manne et al., PROGNOSTIC-SIGNIFICANCE OF BCL-2 EXPRESSION AND P53 NUCLEAR ACCUMULATION IN COLORECTAL ADENOCARCINOMA, International journal of cancer, 74(3), 1997, pp. 346-358
The products of bcl-2 and p53 genes are involved in the regulation of
apoptosis and proliferation and have been associated with prognosis in
several malignancies, including colorectal adenocarcinoma. Although 2
European studies have reported a prognostic significance of Bcl-2 exp
ression in colorectal adenocarcinomas, a study from the United States
did not observe such an association, Therefore, we used immunohistoche
mistry to evaluate the prognostic significance of Bcl-2 expression, p5
3 nuclear accumulation and their concomitant expression in 134 US pati
ents with colorectal adenocarcinoma, Antigen retrieval was required fo
r adequate detection of Bcl-2 expression. Fifty percent of the colorec
tal tumors were classified as expressing Bcl-2, and Bcl-2 expression w
as associated with longer patient survival, Antigen retrieval was not
necessary for detecting nuclear accumulation of p53 by immunohistochem
istry. Nuclear accumulation of p53 was detected in 44% of colorectal a
denocarcinomas and was associated with decreased patient survival, Tum
ors that did not express detectable levels of Bcl-2 but exhibited nucl
ear accumulation of p53 were associated with the shortest patient surv
ival (log rank, p = 0.001). Multivariate Cox regression analysis demon
strated that Bcl-2 expression (p = 0.018), p53 nuclear accumulation (p
= 0.024) and regional lymph-node metastasis (p = 0.005) were independ
ent prognostic factors, Although a trend toward an inverse correlation
between Bcl-2 and p53 expression was observed, the prognostic value o
f Bcl-2 expression was independent of p53 status. Thus, assessment of
both Bcl-2 and p53 status may be valuable in predicting the prognosis
of patients with colorectal adenocarcinomas. (C) 1997 Wiley-Liss, Inc.