title: Aberrant bcl-2 and bax protein expression related to chemotherapy response in neuroblastoma.
abstract: Neuroblastoma (NB) is a tumor of the sympathetic nervous system which develops in young children. It derives from cells of the embryonal neural crest that form many different tissues, including the adrenal medulla and the sympathetic ganglia. Survival rates for patients with neuroblastoma have remained unchanged despite intensive efforts to develop more effective treatment strategies. The intrinsic resistance of many tumor types to antineoplastic therapies and the appearance of resistant cell populations upon relapse of an originally responsive tumor represent major impediments to successful treatment. The possibility exists that these neoplasms, particularly those that have become refractory to chemotherapeutic drugs, may occur in part because of failed apoptosis. In this study we investigated the immunocytochemical expression, before and after a trial of chemotherapy of the bcl-2 and bax proteins in 15 cases of NB, including 8 stroma-poor and 7 stroma-rich NBs. Patients with strong expression of bcl-2 before the treatment had shorter survival than those with weak or moderate expression of the protein (p = 0.004). Moreover, bcl-2 protein expression was correlated to the stroma-poor histotype only after the treatment (p = 0.031). An association between bax protein expression before treatment and longer survival (p = 0.014) was also found. We conclude that bcl-2 and bax expression, before the treatment, could be of prognostic value in neuroblastomas.
authors.affiliation: II Facoltá di Medicina e Chirurgia, Scuola di Specializzasione in Oncologia, Rome, Italy.
authors.forename: Gaia
authors.initials: G
authors.lastname: Gallo
authors.forename: Enrico
authors.initials: E
authors.lastname: Giarnieri
authors.forename: Sandro
authors.initials: S
authors.lastname: Bosco
authors.forename: Carlo
authors.initials: C
authors.lastname: Cappelli
authors.forename: Mauro
authors.initials: M
authors.lastname: Alderisio
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Giovagnoli
authors.forename: Antonio
authors.initials: A
authors.lastname: Giordano
authors.forename: Aldo
authors.initials: A
authors.lastname: Vecchione
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D009447:Neuroblastoma / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D011518:Proto-Oncogene Proteins / Q000096:biosynthesis*; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis*; D016896:Treatment Outcome; D051028:bcl-2-Associated X Protein
chemical_list: C494826:BAX protein, human; D011518:Proto-Oncogene Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D051028:bcl-2-Associated X Protein; D005047:Etoposide; D016190:Carboplatin