title: Absence of prognostic significance of bcl-2 immunopositivity in non-small cell lung cancer: analysis of 427 cases.
abstract: The bcl-2 gene product inhibits apoptosis and is thought to participate in oncogenesis. Association of bcl-2 immunopositivity with improved prognosis of non-small cell lung cancers (NSCLC) is controversial. Although two studies have reported better survival in bcl-2-immunopositive NSCLCs, a third series has contradicted this finding. The authors studied a relatively larger case series involving 427 patients for whom detailed information on long-term follow-up was available to determine the prognostic significance of bcl-2 expression. The study included 252 adenocarcinomas (AC), 111 squamous cell carcinomas (SCC), and 64 large cell carcinomas (LC). After antigen retrieval, sections were immunostained using a monoclonal anti-bcl-2 antibody (1:60, Clone 124, Dako) and the avidin-biotin complex technique. Staining was scored as positive or negative and also on a semiquantitative scale as 0, low (<10%), moderate (10% to 75%), or extensive (>75%). Bcl-2 immunoreactivity was correlated with survival using the actuarial survival method, Kaplan-Meier method, and log-rank test and was not associated with statistically significant differences in survival for NSCLCs (P = .5537). Differences in survival remained insignificant even after NSCLCs were stratified for cell type, stage, or grade, singly or in combination. Therefore, using this method, bcl-2 immunopositivity does not appear to act as an independent prognostic indicator in NSCLCs.
authors.affiliation: Department of Pathology, Baylor College of Medicine, and The Methodist Hospital, Houston, TX 77030, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Anton
authors.forename: R W
authors.initials: RW
authors.lastname: Brown
authors.forename: M
authors.initials: M
authors.lastname: Younes
authors.forename: M M
authors.initials: MM
authors.lastname: Gondo
authors.forename: M A
authors.initials: MA
authors.lastname: Stephenson
authors.forename: P T
authors.initials: PT
authors.lastname: Cagle
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000175:diagnosis / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018287:Carcinoma, Large Cell / Q000737:chemistry / Q000175:diagnosis / Q000401:mortality; D002289:Carcinoma, Non-Small-Cell Lung / Q000737:chemistry* / Q000175:diagnosis / Q000401:mortality*; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000737:chemistry* / Q000175:diagnosis / Q000401:mortality*; D008875:Middle Aged; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis*; D015996:Survival Rate
chemical_list: D019253:Proto-Oncogene Proteins c-bcl-2