Ritter J H, Dresler C M, Wick M R
Division of Surgical Pathology, Washington University School of Medicine, St. Louis, MO, USA.
Hum Pathol. 1995 Nov;26(11):1227-32. doi: 10.1016/0046-8177(95)90198-1.
The bcl-2 gene product (bcl-2 protein, BCLP) prevents apoptotic cell death. Via a 14;18 chromosomal translocation, BCLP is overexpressed in most follicular lymphomas as well as some other non-Hodgkin's lymphomas, and it has also been documented in other nonlymphomatous malignancies. To address the possible prognostic value of this marker in predefined subsets of non-small cell lung carcinoma (NSCLC), the authors studied 126 T1N0M0 cases seen between the years 1986 to 1991 at our institution. Patients were treated by lobectomy (105 cases) or wedge excision (21 cases) with negative margins; neuroendocrine carcinomas of all grades were specifically excluded. The mean follow-up period was 39 months. Immunostaining for BCLP was done using a monoclonal antibody (clone no. 124; DAKO, Carpinteria, CA), and the avidin-biotin-peroxidase complex (ABC) technique. The study cases included 73 adenocarcinomas (ACs) as well as 40 squamous cell (SCC), five adenosquamous (ASC), and eight large cell/poorly differentiated (LCC) carcinomas. As assessed with the Kaplan-Meier method, overall survival was 64% at 5 years (66% AC vs 59% SC). BCLP was detected in 47 of 126 cases (37%) including 32 AC (44%), 10 SCC 925%), two ASC (40%), and three LCC (38%). No significant difference in 5-year survival was noted in a comparison of all cases with BCLP expression (63%) and those without (59%). There was, however, a significant difference in the survival of grade 1 BCLP(+) cases, when compared with grade 2 or 3 BCLP(+) cases (P = .01). A nonstatistically significant trend toward increased survival was observed in BCLP(+) SCC cases (66% 5-year survival in BCLP[+] vs 45% in BCLP[-] [P = .11]). Proportional hazards analysis failed to disclose significant independent risk factors. These data suggest that bcl-2 protein immunoreactivity has limited prognostic value in the pathological evaluation of NSCLC.
bcl - 2基因产物（bcl - 2蛋白，BCLP）可防止细胞凋亡性死亡。通过14号与18号染色体易位，BCLP在大多数滤泡性淋巴瘤以及其他一些非霍奇金淋巴瘤中过表达，并且在其他非淋巴瘤性恶性肿瘤中也有记载。为了探讨该标志物在非小细胞肺癌（NSCLC）预定义亚组中的可能预后价值，作者研究了1986年至1991年间在本机构就诊的126例T1N0M0病例。患者接受肺叶切除术（105例）或楔形切除术（21例），切缘阴性；所有分级的神经内分泌癌均被特意排除。平均随访期为39个月。使用单克隆抗体（克隆号124；DAKO，加利福尼亚州卡平特里亚）和抗生物素蛋白 - 生物素 - 过氧化物酶复合物（ABC）技术对BCLP进行免疫染色。研究病例包括73例腺癌（AC）、40例鳞状细胞癌（SCC）、5例腺鳞癌（ASC）和8例大细胞/低分化癌（LCC）。用Kaplan - Meier方法评估，5年总生存率为64%（AC为66%，SC为59%）。126例病例中有47例（37%）检测到BCLP，包括32例AC（44%）、10例SCC（25%）、2例ASC（40%）和3例LCC（38%）。比较有BCLP表达的所有病例（63%）和无BCLP表达的病例（59%），5年生存率无显著差异。然而，与2级或3级BCLP（+）病例相比，1级BCLP（+）病例的生存率有显著差异（P = 0.01）。在BCLP（+）的SCC病例中观察到生存率增加的非统计学显著趋势（BCLP（+）的5年生存率为66%，BCLP（ - ）为45% [P = 0.11]）。比例风险分析未能揭示显著的独立危险因素。这些数据表明，bcl - 2蛋白免疫反应性在NSCLC的病理评估中预后价值有限。
