Bcl-2, Bax and p53 Expression in Rectal Adenocarcinoma. Correlation with Classic Pathologic Prognostic Factors and Patients' Outcome

Bcl-2, Bax and p53 Expression in Rectal Adenocarcinoma. Correlation with Classic Pathologic Prognostic Factors and Patients' Outcome

Background: Bcl-2 oncoprotein inhibits apoptosis, whereas bax protein promotes apoptosis by enhancing cell susceptibility to apoptotic stimuli. This study examined the bcl-2, bax and p53 expression in rectal adenocarcinomas and their relationship with tumor prognosis. Patients and Methods: Paraffin-...

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Published in:In vivo (Athens) Vol. 21; no. 1; pp. 113 - 118
Main Authors: Tsamandas, Athanassios C, Kardamakis, Dimitrios, Petsas, Theodore, Zolota, V, Vassiliou, V, Matatsoris, T, Kalofonos, Haralabos, Vagianos, Constantine E, Scopa, Chrisoula D
Format: Journal Article
Language:English
Published: Greece International Institute of Anticancer Research 01-01-2007
Subjects:
Adenocarcinoma - diagnosis
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Adult
Aged
bcl-2-Associated X Protein - metabolism
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Recurrence, Local
Prognosis
Proto-Oncogene Proteins c-bcl-2 - metabolism
Rectal Neoplasms - diagnosis
Rectal Neoplasms - mortality
Rectal Neoplasms - pathology
Survival Rate
Tumor Suppressor Protein p53 - metabolism
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Summary:Background: Bcl-2 oncoprotein inhibits apoptosis, whereas bax protein promotes apoptosis by enhancing cell susceptibility to apoptotic stimuli. This study examined the bcl-2, bax and p53 expression in rectal adenocarcinomas and their relationship with tumor prognosis. Patients and Methods: Paraffin-embedded 4-μm tumor sections obtained from patients with rectal adenocarcinoma who underwent colectomy for therapeutic reasons, were analyzed with a standard streptavidin biotin peroxidase method, using polyclonal and monoclonal antibodies. Patients were followed up for 1.5-83 (mean±SD: 47.19±6.2) months. Results: Positive immunoreactivity for bcl-2, bax and p53 was detected in 21 (37%), 28 (50%) and 45 (80%) tumors, respectively. Bax was co-expressed in 17 out of 21 bcl-2(+) cases, whereas p53 was co-expressed in 18 out of 21 bcl-2(+) and 17 out of 28 bax(+) cases. Loss of bax expression was associated with advanced stage and high grade tumors (p<0.01). Local (n=6) or distant (n=5) tumor recurrence was established in 11 cases. All these cases were bax(+), bcl-2(-) and p53(+). Bax and p53 expressions were correlated with adverse outcome (p<0.05) while bcl-2 presence did not influence survival. Bcl-2(-)/bax(+)/p53(+) cases showed lower survival than bax(+)/bcl-2(+)/p53(+)cases (p<0.001). Conclusion: In rectal adenocarcinoma, bax and bcl-2 proteins co-express frequently with p53. Co-expression of bax with p53 protein is associated with poor clinical outcome, especially in cases without concomitant expression of bcl-2.
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ISSN:0258-851X
1791-7549