title: Prognostic significance of Bcl-2 and p53 expression in gastric cancer.
abstract: OBJECTIVE
  Apoptosis regulates cell death and influences cell proliferation and therefore may play an important role in development or growth of various malignant tumors. The Bcl-2 and p53 are closely linked in the regulation of apoptosis. We investigated the prognostic significance of Bcl-2 and p53 expression in patients with gastric cancer.
  
  
  METHODS
  Immunohistochemistry was used to study Bcl-2 and p53 expression in 308 consecutive patients with gastric cancer.
  
  
  RESULTS
  Bcl-2 expression was positive in 39 patients (12.7%) and showed a significant negative correlation with depth of invasion and lymph node metastasis. p53 expression was observed in 105 patients (34.1%) and was significantly associated with depth of invasion, lymph node metastasis, distant metastasis, and intestinal type. Patients with Bcl-2(+) tumors showed a trend to better 5-year survival rate (81%) than those with Bcl-2(-) negative tumors (71%). The 5-year survival rate in p53 positive cases (60%) was significantly lower than that in p53-negative cases (78%). In addition, p53 expression showed a significantly poorer prognosis in both diffuse and intestinal types. In multivariate analysis restricted to patients with R0 resection p53 expression was an independent prognostic factor (relative risk: 2.063). In combined assessment of p53 and Bcl-2 expression the group with p53(+)/Bcl-2(-) tumors showed significantly worse 5-year survival (57%) than the other groups, while best survival was seen in the group with p53(+)/Bcl-2(+) tumors (100%).
  
  
  CONCLUSIONS
  p53 expression is an unfavorable prognostic factor in gastric cancer. Bcl-2 expression may have possible prognostic value when combined with p53 expression.
authors.affiliation: Cancer Research Institute, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, 110-744, Seoul, Korea.
authors.forename: Hyeon Kook
authors.initials: HK
authors.lastname: Lee
authors.forename: Hye Seung
authors.initials: HS
authors.lastname: Lee
authors.forename: Han-Kwang
authors.initials: HK
authors.lastname: Yang
authors.forename: Woo Ho
authors.initials: WH
authors.lastname: Kim
authors.forename: Kuhn Uk
authors.initials: KU
authors.lastname: Lee
authors.forename: Kuk Jin
authors.initials: KJ
authors.lastname: Choe
authors.forename: Jin-Pok
authors.initials: JP
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D019254:Genes, bcl-2; D016158:Genes, p53; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis*; D013274:Stomach Neoplasms / Q000235:genetics* / Q000473:pathology*; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis*
chemical_list: D014408:Biomarkers, Tumor; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53