title: Prognostic significance of Bcl-2 in clinically localized prostate cancer.
abstract: The clinical course of prostate cancer is highly variable and cannot satisfactorily be predicted by histological criteria alone. To study the prognostic significance of Bcl-2 and p53 overexpression in prostate cancer, 137 consecutive radical prostatectomy specimens were examined by immunohistochemistry. Both Bcl-2 and p53 were associated with malignant phenotype. Bcl-2 expression was more frequent in pT3 tumors (31% positive) than in pT2 tumors (5% positive, P = 0.001). p53 overexpression (found in 8%) was associated with high Gleason score (P = 0.03) and increased tumor growth fraction (Ki67 labeling index (LI); P = 0.017). Survival analysis showed that Bcl-2 expression (P = 0.03), high Ki67 LI (P = 0.018), high grade (P = 0.0037), advanced local stage (P = 0.0005), and positive lymph nodes (P = 0.026) were predictors of progression. The combined analysis of Ki67 LI and Bcl-2 allowed the distinction of three groups with different clinical outcome. Prognosis was best in Bcl-2-negative tumors with low Ki67 LI, worst in Bcl-2-positive tumors with high Ki67 LI, and intermediate in the remaining tumors (P = 0.03). These data suggest that altered expression of both Bcl-2 and p53 play a role in prostate cancer progression. Combined analysis of factors regulating both apoptosis and cell proliferation may be relevant in prostate cancer.
authors.affiliation: Institute for Pathology, University Computer Center, Basel, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Bubendorf
authors.forename: G
authors.initials: G
authors.lastname: Sauter
authors.forename: H
authors.initials: H
authors.lastname: Moch
authors.forename: P
authors.initials: P
authors.lastname: Jordan
authors.forename: A
authors.initials: A
authors.lastname: Blöchlinger
authors.forename: T C
authors.initials: TC
authors.lastname: Gasser
authors.forename: M J
authors.initials: MJ
authors.lastname: Mihatsch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D002455:Cell Division; D018450:Disease Progression; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis; D009687:Nuclear Proteins / Q000032:analysis; D010641:Phenotype; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000737:chemistry* / Q000473:pathology; D011518:Proto-Oncogene Proteins / Q000032:analysis*; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D009687:Nuclear Proteins; D011518:Proto-Oncogene Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53