Bcl-X expression in esophageal squamous cell carcinoma: Association with tumor progression and prognosis

Background and Objectives: Bcl-2 family proteins are regulators of programm ed cell death and important in the development and progression of human var ious tumors. The role of these proteins in the development, progression and differentiation of esophageal squamous cell carcinoma (ESCC) is unclear. Methods: We investigated the expression of Bcl-2, Bcl-X, and Bax using immu nohistochemistry in 86 ESCCs, and scored the expression by the weighted sco re. Results: Bcl-2 expression related to pT category (P = 0.043) and histologic al grade (P = 0.001). Bcl-X expression related to pT category (P = 0.003), pN category (P = 0.041) and the number of positive nodes (P = 0.036), and h ad a tendency to relate to histological grade (P = 0.086). Bax expression h ad a tendency to relate to pN category (P = 0.081). The inverse relationshi p between Bcl-2 and Bcl-X expression was detected (P = 0.001), while the po sitive one between Bcl-X and Bax expression was detected (P = 0.014). Patie nts with low Bcl-X weighted score had a significantly longer survival compa red with those with high Bcl-X weighted score. Multivariate analysis reveal ed Bcl-X expression as the independent prognostic factors (P = 0.022). Conclusions: These results imply that Bcl-2 family proteins, especially Bcl -X, may contribute to the progression in ESCC. J. Surg. Oncol. 2001;78:116- 123. (C) 2001 Wiley-Liss, Inc.