title: Prognostic value of Bcl-2 and Bax tumor cell expression in patients with non muscle-invasive bladder cancer receiving bacillus Calmette-Guerin immunotherapy.
abstract: Apoptosis is the distinctive form of programmed cell death that complements cell proliferation in maintaining normal tissue homeostasis. The significance of constitutive apoptosis in the recurrence of Non Muscle Invasive Bladder Cancer has yet to be investigated. The aim of this study is to investigate the prognostic significance of Bax and Bcl-2 in terms of recurrence after BCG immunotherapy. Immunohistochemical analysis was performed on frozen biopsies to evaluate bcl-2 and Bax proteins expression in 28 cases of NMIBC. All patients with confirmed NMIBC were treated with intravesical BCG-immunotherapy. The follow up was performed for 26 months. The correlation between clinicopathological, immunohistochemical data and the response to BCG therapy was performed. Univariate analysis showed that, PT1 stage, High grade and Bax expression increased significantly the risk of recurrence (P = 0.015, P = 0.015 and P= 0.034 respectively). In addition, multivariate analysis selected the model involving stage, age, Bax and Bcl-2 expression as the best independent variables of recurrence. In conclusion, the expression of Bcl-2 and Bax in NMIBC could have a prognostic value in assessing the risk of recurrence after BCG immunotherapy. These findings require further investigations on larger cohort in order to ascertain new molecular markers of the response to BCG immunotherapy.
authors.affiliation: Pasteur Institute of Tunis, Laboratory of Human and Experimantal Pathology, Tunis, Tunisia. faouziaagili@yahoo.fr
authors.forename: Faouzia
authors.initials: F
authors.lastname: Ajili
authors.forename: Belhassen
authors.initials: B
authors.lastname: Kaabi
authors.forename: Amine
authors.initials: A
authors.lastname: Darouiche
authors.forename: Haifa
authors.initials: H
authors.lastname: Tounsi
authors.forename: Nadia
authors.initials: N
authors.lastname: Kourda
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chebil
authors.forename: Mohamed
authors.initials: M
authors.lastname: Manai
authors.forename: Samir
authors.initials: S
authors.lastname: Boubaker
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000502:physiology; D001500:BCG Vaccine / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000032:analysis*; D002295:Carcinoma, Transitional Cell / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007167:Immunotherapy / Q000379:methods; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis / Q000096:biosynthesis*; D001749:Urinary Bladder Neoplasms / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D051028:bcl-2-Associated X Protein / Q000032:analysis / Q000096:biosynthesis*
chemical_list: D001500:BCG Vaccine; D014408:Biomarkers, Tumor; D019253:Proto-Oncogene Proteins c-bcl-2; D051028:bcl-2-Associated X Protein