Bcl-2 expression and other clinicopathologic parameters in uterine leiomyosarcoma.
BACKGROUND
The bcl-2 protein, which is involved in cell-cycle regulation and apoptosis, seems to play an important role in the growth of tumors. Until recently, only one study described the frequent expression of bcl-2 in uterine leiomyosarcomas (LMS) and indicated its important prognostic role. Thus, the aims of the present study were to examine bcl-2 expression in patients with uterine LMS and to determine if the expression of this protein would influence the prognosis. In addition, a possible association between bcl-2 expression and various clinicopathologic parameters was evaluated.


METHODS
Bcl-2 expression was investigated using immunohistochemical techniques on paraffin-embedded tissue from 21 patients with uterine LMS. The immunohistochemical findings were correlated with different clinicopathologic parameters (FIGO stage, age, vascular-space involvement and recurrence of disease) of the patients.


RESULTS
Bcl-2 was expressed in 57% (12/21) of uterine LMS: 3/12 (25%) stained weakly positive, 3/12 (25%) stained moderately positive and 6/12 (50%) stained strongly positive. Nine (43%) cases were negative. Evaluation of the correlation between bcl-2 expression and several clinicopathologic parameters identified a significant negative correlation between vascular-space involvement and bcl-2 expression (p=0.04). The relationship between bcl-2 expression and FIGO stage, age and recurrence of disease did not reach statistical significance. A univariate Cox model revealed significantly longer overall survival in women with bcl-2-positive LMS compared with women with bcl-2-negative LMS (p=0.03).


CONCLUSIONS
Significant negative correlation was found between bcl-2 expression and vascular-space involvement and improved survival rates in patients with bcl-2-positive tumors. Though limited by the small number of patients, these data indicate the role of bcl-2 expression in uterine LMS.
Bodner
Klaus
K
Departments of Gynecology & Obstetrics, University of Vienna Medical School, Vienna, Austria. klausbodner@yahoo.com
Bodner-Adler
Barbara
B
Kimberger
Oliver
O
Czerwenka
Klaus
K
Mayerhofer
Klaus
K
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D007890:Leiomyosarcoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis*; D012189:Retrospective Studies; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D014599:Uterus / Q000473:pathology
D014408:Biomarkers, Tumor; D019253:Proto-Oncogene Proteins c-bcl-2