Kim Taeyeong, Lim Seung Taek, Choi Hyang Suk, Cho In-Jeong, Noh Hany, Lee Jong-In, Han Airi
Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Oncology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Sci Rep. 2025 Jan 6;15(1):920. doi: 10.1038/s41598-024-83302-w.
Bcl-2, a key regulator of cellular apoptosis, is typically linked to adverse prognosis in solid tumors due to its inhibition of apoptotic cell death and promotion of cellular proliferation, leading to tumor progression. However, studies on Bcl-2 in breast cancer have shown inconsistent results, with some indicating favorable outcomes. This study aims to determine the subtype-specific role of Bcl-2 in breast cancer. Female breast cancer patients who completed primary treatment at Wonju Severance Hospital, Korea, from 2004 to 2018 were included. Clinicopathological characteristics, including Bcl-2 expression, were collected, and patients were classified based on Bcl-2 expression in more than or less than 10% of tumor cells. Kaplan-Meier curves compared recurrence-free interval (RFI) and overall survival (OS). The final cohort of 617 patients, with a mean age of 54.79 ± 11.2 years, showed no overall survival difference by Bcl-2 status (p = 0.616). In HER2-overexpressed patients, high Bcl-2 expression was linked to poor prognosis (p = 0.0021). This trend appeared in ER-positive (p = 0.297) and ER-negative (p = 0.029) subgroups. Conversely, in HER2-negative patients, Bcl-2 overexpression indicated better survival (p = 0.009), consistent in ER-positive (p = 0.259) and ER-negative (p = 0.010) subgroups. Bcl-2's impact on survival varies with HER2 status, showing poor prognosis in HER2-overexpressed and better prognosis in HER2-negative patients.
Bcl-2是细胞凋亡的关键调节因子，由于其抑制凋亡性细胞死亡并促进细胞增殖，通常与实体瘤的不良预后相关，从而导致肿瘤进展。然而，关于Bcl-2在乳腺癌中的研究结果并不一致，有些研究表明其预后良好。本研究旨在确定Bcl-2在乳腺癌中的亚型特异性作用。纳入了2004年至2018年在韩国原州Severance医院完成初始治疗的女性乳腺癌患者。收集了包括Bcl-2表达在内的临床病理特征，并根据肿瘤细胞中Bcl-2表达超过或低于10%对患者进行分类。采用Kaplan-Meier曲线比较无复发生存期（RFI）和总生存期（OS）。最终队列的617例患者，平均年龄为54.79±11.2岁，Bcl-2状态对总生存期无差异（p=0.616）。在HER2过表达的患者中，高Bcl-2表达与不良预后相关（p=0.0021）。这种趋势在雌激素受体（ER）阳性（p=0.297）和ER阴性（p=0.029）亚组中均有出现。相反，在HER2阴性患者中，Bcl-2过表达提示生存期更好（p=0.009），在ER阳性（p=0.259）和ER阴性（p=0.010）亚组中均一致。Bcl-2对生存的影响因HER2状态而异，在HER2过表达患者中预后不良，在HER2阴性患者中预后较好。
