The clinical relevance of Bcl-2, Rb and p53 expression in advanced non-small cell lung cancer.
OBJECTIVE
The aim of this study was to evaluate the impact of Bcl-2, retinoblastoma (Rb) and p53 proteins on overall survival of 102 patients with locally advanced and metastatic NSCLC who underwent cisplatin-based chemotherapy.


METHODS
Paraffin-embedded bronchial biopsy and fine-needle biopsy specimens were evaluated by an immunostaining method.


RESULTS
Median age of analyzed patients was 61 years. Male/female ratio was 88/14. There were 10 (10%) patients with stage IIIA, 37 (36%) with stage IIIB and 55 (54%) with stage IV NSCLC. Only 15 (15%) tumor specimens had no detectable alterations for analyzed factors. Forty-six samples (45%) had positive immunostaining for p53, 61 (60%) had negative immunostaining for Rb and 8 (8%) had positive immunostaining for Bcl-2. Median and 5-year survival of analyzed population was 12 months and 6%, respectively. In univariate analysis Bcl-2 overexpression, stage (III versus IV) and normal lactate dehydrogenase (LDH) serum levels were associated with better overall survival (P<0.02, 0.001 and 0.03). In multivariate analysis, only stage was identified as an independent predictive factor.


CONCLUSIONS
High frequency of Rb and Bcl-2 loss was detected in patients with advanced NSCLC. P53, Rb and Bcl-2 have not been shown to be independent predictors of survival even if Bcl-2 might have a particular relevance in patients with advanced NSCLC and should be better explored in this setting.
Gregorc
Vanesa
V
Division of Medical Oncology, Policlinico Monteluce, Via Brunamonti 51, Perugia 06122, Italy. gregorc.vanesa@hsr.it
Darwish
Samir
S
Ludovini
Vienna
V
Pistola
Lorenza
L
De Angelis
Verena
V
Mihaylova
Zhasmina
Z
Bellezza
Guido
G
Sidoni
Angelo
A
Cavaliere
Antonio
A
Bucciarelli
Emilio
E
Massaro
Giovanni
G
Tonato
Maurizio
M
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009363:Neoplasm Proteins / Q000096:biosynthesis*; D009367:Neoplasm Staging; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis; D012044:Regression Analysis; D016160:Retinoblastoma Protein / Q000096:biosynthesis; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis
D009363:Neoplasm Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D016160:Retinoblastoma Protein; D016159:Tumor Suppressor Protein p53