Expression of Bcl-2 and p53 protein in resectable invasive ductal carcinoma of the pancreas: Effects on clinical outcome and efficacy of adjuvant chemotherapy

Background and Objectives: p53 tumor suppressor gene has a dual role as a t rigger of apoptosis and as an initiator of DNA repair. The Bcl-2 can work t o protect cells from apoptosis, which is induced by p53 gene. These facts s uggest the significant role of these genes in the genesis and progression o f various tumors. The present study was designed to assess the significance of p53 and Bcl-2 protein (pBcl-2) expression on resectable invasive ductal carcinoma (IDC) of the pancreas. Methods: The present study included 63 IDCs, which were resected between 19 82 and 1998. pBcl-2 and p53 were stained immunohistochemically with monoclo nal antibodies. Results: pBcl-2 was expressed in 16 (25.4%), and p53 was positively express ed in 32 out of 63 IDCs (50.8%); however, expression of pBcl-2, did not nec essarily correlate with that of p53. Although p53 expression did not show a ny significant influence on the patients' survival, pBcl-2(+) patients show ed a higher survival than pBcl-2(-) patients for both p.53(+) and p53(-) pa tients, which suggested that pBcl-2 expression had a more significant effec t on the survival of patients than p53 expression. On the other hand, there were no differences in the survival curve between the adjuvant chemotherap y (ACT) group and the surgery alone (SA) group. pBcl-2 expression had no in fluence on the effect of ACT, the ACT group showed a significantly better s urvival than the SA group for p53(+) IDC patients. Conclusions: pBcl-2 expression is a beneficial prognostic factor for patien ts with IDC, whereas p53 expression may be beneficial in the prediction of the effects of adjuvant chemotherapy on patients with IDC. (C) 2001 Wiley-L iss, Inc.