Increased bcl-2 expression is associated with primary resistance to chemotherapy in human epithelial ovarian cancer.
OBJECTIVE
bcl-2, an anti-apoptotic factor, has a role in the pathogenesis of ovarian cancer as well as in resistance to chemotherapy.


METHODS
20 benign, and 26 malignant epithelial ovarian tissues were analyzed for bcl-2 protein and mutant p53 by enzyme-immunoassay (EIA). Flowcytometric analysis was also performed. Patients of malignant group were followed up to monitor overall survival and primary resistance to chemotherapy.


RESULTS
bcl-2 was significantly higher in malignant group than benign group (p < 0.001). A cutoff value was determined for bcl-2 (63.8 kU/g protein). At this cutoff, sensitivity is 80.7%, and specificity is 85%. Using chi square analysis, a significant correlation was found between bcl-2 and FIGO stage (p = 0.01), overall survival (p = 0.01), as well as primary resistance to chemotherapy (p = 0.03). By correlation coefficient analysis the relation between bcl-2 and synthetic phase fraction was highly significant (p = 0.002). Bcl-2, p53, and FIGO stage were significantly correlated to poor survival (p = 0.01) in univariate analysis. However, in multivariate analysis, only FIGO stage, and p53 were independent risk factors.


CONCLUSIONS
EIA could be a useful tool for investigating the prognostic value of bcl-2, and its possible prediction of platinum resistance in epithelial ovarian cancer. This might help in selecting patients for future anti-bcl-2 therapy.
Kassim
S K
SK
Department of Biochemistry, Faculty of Medicine, Ain Shams University, Cairo, Egypt. samar.kassim@usa.net
Ali
H S
HS
Sallam
M M
MM
Fayed
S T
ST
Seada
L S
LS
abd-Elkawy
E
E
Seada
M A
MA
Khalifa
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D015153:Blotting, Western; D019008:Drug Resistance, Neoplasm / Q000235:genetics; D004359:Drug Therapy, Combination; D004848:Epithelium / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D019254:Genes, bcl-2 / Q000235:genetics*; D006801:Humans; D007124:Immunoenzyme Techniques; D007150:Immunohistochemistry; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000378:metabolism* / Q000473:pathology; D010984:Platinum / Q000627:therapeutic use; D011379:Prognosis; D012372:ROC Curve; D016196:S Phase; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000235:genetics
D016159:Tumor Suppressor Protein p53; D010984:Platinum