title: P53, bcl-2, and bax: their relationship and effect on prognosis in early stage epithelial ovarian carcinoma.
abstract: The prognosis of ovarian carcinoma, even in the early stages (FIGO I-II), continues to present a challenge despite advances in the understanding of pathophysiology and treatment. In a series of 106 patients with epithelial carcinomas in FIGO stages IA-IIC, a number of prognostic factors (age, FIGO stage, histopathologic type, and tumor grade) were studied in relation to important regulators of apoptosis (p53, bcl-2, and bax). Immunohistochemical techniques were used. All the patients received adjuvant radiotherapy after the primary surgery. Univariate analysis showed that expression of p53 was highly significantly associated with tumor grade (P = 0.007) and survival status (P = 0.046). Positive bcl-2 staining was associated with serous (P = 0.0002) and endometrioid tumor subtypes, but not with the survival rate. A positive bax status was associated with younger age (P = 0.012) and a more favorable probability of survival. A significant association between the bcl-2 and bax status of the tumors and histopathologic subtypes and grades was noted. The most favorable subgroup of tumors was that with a combination of positive bax staining and negative p53 staining. In a multivariate Cox analysis, tumor grade (P = 0.0006) and bax status (P = 0.020) were independent and significant prognostic factors.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital, Uppsala, Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Skirnisdóttir
authors.forename: B
authors.initials: B
authors.lastname: Sorbe
authors.forename: T
authors.initials: T
authors.lastname: Seidal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D019254:Genes, bcl-2 / Q000235:genetics; D016158:Genes, p53 / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000096:biosynthesis* / Q000235:genetics; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis* / Q000235:genetics; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis* / Q000235:genetics; D051028:bcl-2-Associated X Protein
chemical_list: C494826:BAX protein, human; D011518:Proto-Oncogene Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53; D051028:bcl-2-Associated X Protein