Expression of bcl-2 in testicular carcinoma: correlation with tumor progression and MDR1/Pgp.
BACKGROUND
The expression of bcl-2 has been studied extensively in a variety of human tumors. However, there is a lack of clinical data regarding its expression in germ cell testicular tumors (GCTTs).


METHODS
In this study, the authors screened 70 patients with GCTTs for bcl-2 expression using immunohistochemistry (IHC) and the streptavidin-biotin-alkaline phosphatase method. This expression was also correlated with the metastatic behavior, clinical stages, and multidrug resistance gene product protein (MDR1/Pgp) immunostaining of GCTTs.


RESULTS
Overall, 41 carcinomas (58%) stained positively with anti-bcl-2 monoclonal antibody. According to histologic type, these lesions with positive staining included 11 of 26 seminomas (42.3%) and 30 of 44 nonseminomatous germ cell testicular tumors (NSGCTs) (68%). The incidence of bcl-2 immunostaining was higher (P = 0.05, two-tailed Fisher's exact test) among NSGCTs than among seminomas. The expression of bcl-2 was more prevalent among tumors from patients with metastases than among tumors from metastasis free patients (P = 0.000). There was a significant difference between the three stages of disease in the expression of bcl-2 (chi2 = 0.000), i.e., bcl-2 expression was clearly dominant among tumors at advanced stages. A significant association between bcl-2 and Pgp immunostaining was established (P = 0.004).


CONCLUSIONS
These findings revealed that bcl-2 expression occurs in GCTTs. Furthermore, they suggest that bcl-2 is associated with a more advanced malignant phenotype of this tumor.
Department of Cytopathology, National Institute of Oncology, Budapest, Hungary.
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H
Eid
M
M
Gulyás
L
L
Géczi
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Bodrogi
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E
Institoris
M
M
Bak
D000293:Adolescent; D000328:Adult; D000368:Aged; D018450:Disease Progression; D015870:Gene Expression; D019254:Genes, bcl-2 / Q000235:genetics*; D018237:Germinoma / Q000235:genetics* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics; D013736:Testicular Neoplasms / Q000235:genetics* / Q000473:pathology
D019253:Proto-Oncogene Proteins c-bcl-2