Clinical significance and prognostic value of apoptosis relayed proteins in superficial esophageal squamous cell carcinoma

Background: The purpose of the present study was to examine the expression of cell cycle regulators [p53, p21(WAF1/CIP1) (p21), and Rb] and apoptosis related proteins Bax and Bcl-X-L and to evaluate the relationship between t heir expressions and clinicopathological findings in patients with superfic ial squamous cell carcinomas of the esophagus. Methods: We immunohistochemically investigated the expression of p53, p21, Rb, Bax, and Bcl-X-L in 79 patients with superficial esophageal carcinoma. Results: p21 overexpression was found in mucosal carcinoma (P = 0.05) and a high Bcl-X-L score was observed for submucosal carcinoma (P = 0.03). The p atients with high Bcl-X-L score had more frequent lymphatic invasion and ly mph node metastasis than did those with low Bcl-X-L score (P < 0.05). Univa riate analysis revealed significantly shorter survival in patients with hig h Bcl-X-L expression than in those with low Bcl-X-L expression, but Bcl-X-L expression was not identified as an independent prognostic factor by multi variate analysis. Conclusions: Because Bcl-X-L. expression correlated well with depth of tumo r invasion, lymphatic invasion, and lymph node metastasis, examination of B cl-X-L expression will help to estimate the properties in superficial squam ous cell carcinoma of the esophagus.