Chatla Chakrapani, Jhala Nirag C, Katkoori Venkat R, Alexander Dominik, Meleth Sreelatha, Grizzle William E, Manne Upender
Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Cancer Biomark. 2005;1(4-5):241-50. doi: 10.3233/cbm-2005-14-507.
Although decreased or lack of expression of Bcl-2 has been correlated with advanced tumor stage and shortened patient survival in colorectal cancer (CRC), its value in predicting the recurrence has not been well explored. Therefore, we assessed the usefulness of phenotypic expression of Bcl-2 in non-Hispanic Caucasian patients with CRCs in identifying risk of recurrence. Archival tissues of 92 Stage II and 66 Stage III primary CRCs were evaluated for immunohistochemical expression of Bcl-2. None of these patients received either pre- or post-surgical adjuvant therapies. Kaplan-Meier and Cox proportional hazards methods were used to estimate the rates of recurrence and survival according to Bcl-2 expression. Decreased expression of Bcl-2 was associated with an increased rate of recurrence in patients with Stage II CRCs (5-year log-rank test P=0.0015; Hazard Ratio (HR)=3.90, 95%C.I.:1.55-9.77) but not with Stage III CRCs (5-year log-rank test P=0.6058; HR=1.07, 95%C.I.:0.47-2.45) after adjusting for other demographic and clinicopathological features. Furthermore, decreased expression of Bcl-2 was an indicator of short survival in patients with Stage II CRCs but not with Stage III CRCs. Thus, decreased or lack of Bcl-2 expression in primary CRCs may serve as a molecular biomarker of high risk of recurrence for Caucasian patients with Stage II CRCs. These findings might be useful in identifying biologically aggressive phenotypes of Stage II CRCs, and may aid the oncologist in designing maximally appropriate therapeutic regimens.
虽然在结直肠癌（CRC）中，Bcl-2表达降低或缺失与肿瘤晚期及患者生存期缩短相关，但其在预测复发方面的价值尚未得到充分探究。因此，我们评估了非西班牙裔白人CRC患者中Bcl-2的表型表达在识别复发风险中的作用。对92例II期和66例III期原发性CRC的存档组织进行Bcl-2免疫组化表达评估。这些患者均未接受术前或术后辅助治疗。采用Kaplan-Meier法和Cox比例风险法根据Bcl-2表达估计复发率和生存率。在调整其他人口统计学和临床病理特征后，II期CRC患者中Bcl-2表达降低与复发率增加相关（5年对数秩检验P=0.0015；风险比（HR）=3.90，95%置信区间：1.55-9.77），而III期CRC患者则不然（5年对数秩检验P=0.6058；HR=1.07，95%置信区间：0.47-2.45）。此外，II期CRC患者中Bcl-2表达降低是生存期短的一个指标，而III期CRC患者则不是。因此，原发性CRC中Bcl-2表达降低或缺失可能作为II期CRC白人患者高复发风险的分子生物标志物。这些发现可能有助于识别II期CRC具有生物学侵袭性的表型，并可能帮助肿瘤学家设计最合适的治疗方案。
