title: BCL-2 expression is prognostic for improved survival in non-small cell lung cancer.
abstract: OBJECTIVE
  We used a large patient population to identify immunohistochemical biomarkers to enable improved prognostication in patients with non-small cell lung carcinoma (NSCLC).
  
  
  METHODS
  A tissue microarray was constructed using duplicate 0.6 mm cores of formalin-fixed paraffin-embedded tissue blocks from 609 patients with NSCLC. Immunohistochemical was used to detect 11 biomarkers including epidermal growth factor receptor, Her2, Her3, p53, p63, bcl-1, bcl-2, Thyroid transcription factor, carcinoembryonic antigen, chromogranin, and synaptophysin. A clinical database was generated prospectively at the time of tissue collection. Survival outcomes were obtained from a Provincial Cancer Registry database. Univariate and multivariate analyses were performed to look for a relationship between biomarker expression, smoking history, and survival.
  
  
  RESULTS
  Survival data for 535 cases were available. As of June 2005, 429 patients (80%) had died; of these 286 (54%) died of lung cancer, 117 (22%) died of other known causes, and for 26 (5%) the cause of death was not available. Univariate analysis revealed that bcl-2 (p = 0.007) was the only biomarker prognostic for improved overall survival (OS). bcl-2 (p = 0.021) and p63 (p = 0.025) were both found to be prognostic for improved disease-specific survival (DSS). Multivariate analysis (using age and biomarker expression) revealed that bcl-2 expression is prognostic for improved OS (p = 0.005) and DSS (p = 0.021).
  
  
  CONCLUSIONS
  Our results suggest that bcl-2 expression is prognostic for improved OS and DSS in NSCLC. Testing for bcl-2 expression in a prospective study will help to determine its clinical relevance in prognostication.
authors.affiliation: Division of Medical Oncology, BC Cancer Agency, Vancouver, British Columbia, Canada. drenouf@bccancer.bc.ca
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Renouf
authors.forename: Richard
authors.initials: R
authors.lastname: Wood-Baker
authors.forename: Diana N
authors.initials: DN
authors.lastname: Ionescu
authors.forename: Samuel
authors.initials: S
authors.lastname: Leung
authors.forename: Hamid
authors.initials: H
authors.lastname: Masoudi
authors.forename: Cyril B
authors.initials: CB
authors.lastname: Gilks
authors.forename: Janessa
authors.initials: J
authors.lastname: Laskin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000737:chemistry / Q000401:mortality*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000737:chemistry / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis*; D046888:Tissue Array Analysis
chemical_list: D019253:Proto-Oncogene Proteins c-bcl-2