title: Prognostic significance of biological apoptosis factors in gastric cancer.
abstract: OBJECTIVE
  Gastric cancer is a biologically heterogeneous disease containing many genetic and epigenetic alterations. In our study, the expression status of apoptosis-inducing p53 and apoptosis-inhibiting Bcl-2 in gastric cancer and their relation with prognosis, if any, was investigated.
  
  
  METHODS
  Patients that were being followed in our clinic and had histopathologically diagnosed gastric adenocarcinoma were included in this study. The p53 and bcl-2 expressions were investigated immunohistochemically and patients were grouped according to p53 and Bcl-2 expression as follows: group A: both p53 and Bcl-2 negative; group B: p53 positive and Bcl-2 negative; group C: p53 negative and Bcl-2 positive; group D: both p53 and Bcl-2 positive.
  
  
  RESULTS
  In 19 (51.4%) patients positive immunostaining with p53 was observed, while negative in 18 (48.6%). A significant relationship between the metastatic ability of the tumor and p53 expression was determined (p=0.004). In 78.6% of the metastatic tumors no p53 expression was observed, while in 69.6% of the non-metastatic tumors p53 expression was positive. No significant relationship was detected between p53 expression and survival. Positive immunostaining with Bcl-2 was observed in 9 (16.7%) patients, and negative in 45 (83.3%). No significant relationship was determined between the Bcl-2 expression and the depth of invasion, dissemination to lymph nodes and metastatic ability of the tumor. A borderline statistically significant relationship was determined between the Bcl-2 expression and survival (p=0.051). Group B patients showed a statistically significant survival difference compared with the other groups (p=0.022).
  
  
  CONCLUSIONS
  The results of this study suggest that concurrent evaluation of p53 and Bcl-2 in patients with gastric adenocarcinoma may have prognostic importance.
authors.affiliation: Department of Pathology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Sezer
authors.forename: M
authors.initials: M
authors.lastname: Yildirim
authors.forename: M
authors.initials: M
authors.lastname: Yildiz
authors.forename: A
authors.initials: A
authors.lastname: Sezgin
authors.forename: U
authors.initials: U
authors.lastname: Donem Dilli
authors.forename: S
authors.initials: S
authors.lastname: Goktas
authors.forename: N
authors.initials: N
authors.lastname: Bulbuller
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry* / Q000401:mortality / Q000556:secondary; D000368:Aged; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000032:analysis*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis*; D013274:Stomach Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D013997:Time Factors; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D019253:Proto-Oncogene Proteins c-bcl-2; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53