Prognostic significance of Bcl-2 and p53 expression in gastric cancer.
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.
Lee
Hyeon Kook
HK
Cancer Research Institute, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, 110-744, Seoul, Korea.
Lee
Hye Seung
HS
Yang
Han-Kwang
HK
Kim
Woo Ho
WH
Lee
Kuhn Uk
KU
Choe
Kuk Jin
KJ
Kim
Jin-Pok
JP
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*
D014408:Biomarkers, Tumor; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53