Georgiou A, Gomatos I P, Ferekidis E, Syrigos K, Bistola V, Giotakis J, Adamopoulos G, Androulakis G
Department of Otolaryngology, Hippokration Hospital, Athens, Greece.
Eur J Surg Oncol. 2001 Sep;27(6):574-80. doi: 10.1053/ejso.2001.1131.
This study was designed to examine the prognostic significance of the coexpression of three genes (bax, bcl-2 and p53) which play a critical role in the apoptotic mechanisms in patients with squamous cell laryngeal carcinoma.
The immunohistochemical expression of bcl-2, bax and p53 genes was retrospectively examined in 38 patients with squamous cell laryngeal carcinoma and in five controls (necrotomic tissue). Tissue specimens were obtained both during the diagnostic biopsy and at the time of surgery. Clinicopathological and survival data were correlated with the staining results.
Bcl-2 protein expression (P=0.0472), stage (P=0.0087) and lymph-node involvement (P=0.0488) were found to be independent prognostic factors. Increased bcl-2 protein expression correlated with a better 5-year survival (P=0.0472). Patients who were bcl-2(-)/p53(-) (n=25) or bax(+)/bcl-2(-) (n=13) had a significantly worse overall survival (P=0.0305 and P=0.0482, respectively). Similarly, patients who were bax(+)/bcl-2(-)/p53(-) (n=11) also had a worse 5-year survival compared with the rest of the group (P=0.0088). Changes that were noticed in bax and p53 protein expression from the time of biopsy until the time of surgery did not correlate with a significant increase in the overall survival.
The expression of bcl-2 gene appears to be an independent prognostic factor for patients with laryngeal carcinoma. The coexpression of the genes studied can be used to determine aggressive clinical phenotypes.
本研究旨在探讨在喉鳞状细胞癌患者的凋亡机制中起关键作用的三种基因（bax、bcl-2和p53）共表达的预后意义。
回顾性检测38例喉鳞状细胞癌患者及5例对照（坏死组织）中bcl-2、bax和p53基因的免疫组化表达。组织标本在诊断性活检和手术时获取。临床病理和生存数据与染色结果相关联。
发现bcl-2蛋白表达（P=0.0472）、分期（P=0.0087）和淋巴结受累（P=0.0488）是独立的预后因素。bcl-2蛋白表达增加与较好的5年生存率相关（P=0.0472）。bcl-2（-）/p53（-）（n=25）或bax（+）/bcl-2（-）（n=13）的患者总体生存率显著较差（分别为P=0.0305和P=0.0482）。同样，bax（+）/bcl-2（-）/p53（-）（n=11）的患者与该组其他患者相比5年生存率也较差（P=0.0088）。从活检到手术期间bax和p53蛋白表达的变化与总体生存率的显著提高无关。
bcl-2基因的表达似乎是喉癌患者的一个独立预后因素。所研究基因的共表达可用于确定侵袭性临床表型。
