Protein Expression of bax, bcl‐2, and p53 in Patients with Non‐Hodgkin's Gastric Lymphoma: Prognostic Significance

• Published in: World journal of surgery Vol. 24; no. 5; pp. 608 - 614
• Main Authors: Charalambous, George K., Gomatos, Ilias P., Konstadoulakis, Manoussos M., Messaris, Evangelos G., Manouras, Andreas J., Apostolou, Anastasia E., Leandros, Emmanuel A., Karayannis, Maria K., Androulakis, George A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer‐Verlag 01-05-2000; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; bcl-2-Associated X Protein; Biological and medical sciences; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Lymphoma, Non-Hodgkin - metabolism; Lymphoma, Non-Hodgkin - mortality; Male; Medical sciences; Middle Aged; Prognosis; Proto-Oncogene Proteins - biosynthesis; Proto-Oncogene Proteins c-bcl-2 - biosynthesis; Retrospective Studies; Stomach Neoplasms - metabolism; Stomach Neoplasms - mortality; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Survival Rate; Tumor Suppressor Protein p53 - biosynthesis; Tumors; Human; Immunohistochemistry; Stomach; Prognosis; Malignant hemopathy; Gastrectomy; Non Hodgkin lymphoma; Survival; Retrospective; Pathology; TP53 Gene; Surgery; Lymphoproliferative syndrome; Digestive diseases; Predictive factor; Gastric disease
• DOI: 10.1007/s002689910098
• EISSN: 1432-2323
• ISSN: 0364-2313

.
The biologic significance of bcl‐2, bax, and p53 gene expression in patients with non‐Hodgkin's gastric lymphoma is unknown. We examined the prognostic value of these genes in 36 patients with gastric lymphoma treated in our clinic between 1990 and 1995. Paraffin‐embedded specimens from 36 patients who underwent primary resection of the stomach for gastric lymphoma were analyzed immunohistochemically for p53, bax, and bcl‐2 gene expression. Expression of bax was seen in 24 of 36 patients (66.7%), p53 expression was found in 8 of 36 tumors (22.2%), and bcl‐2 cytoplasmic staining was detected in 6 of 36 patients (16.7%). We performed a univariate analysis to examine the possible correlation between the expression of these genes and the survival of our patients. Expression of bax protein proved to be a statistically significant prognostic factor (p= 0.049). Protein expression of p53 and bcl‐2 did not statistically correlate with survival. In the bcl‐2‐negative (−) patient group (30 patients), those who were bax‐positive had a statistically significant better survival than those who were bax‐negative (63.3% vs. 36.7%, p= 0.03). There was also a statistically significant correlation between p53 expression and the grade of the tumor (p= 0.0014). P53 protein expression increased along with the grade. Expression of bax is a significant prognostic factor in patients with gastric lymphoma. Its prognostic value increases significantly when studied in bcl‐2‐negative patients; but expression of bax failed to be an independent prognostic factor. Expression of bcl‐2 and p53 has no prognostic significance. Expression of p53 seems to represent a marker for loss of differentiation.