Bubendorf L, Sauter G, Moch H, Jordan P, Blöchlinger A, Gasser T C, Mihatsch M J
Institute for Pathology, University Computer Center, Basel, Switzerland.
Am J Pathol. 1996 May;148(5):1557-65.
The clinical course of prostate cancer is highly variable and cannot satisfactorily be predicted by histological criteria alone. To study the prognostic significance of Bcl-2 and p53 overexpression in prostate cancer, 137 consecutive radical prostatectomy specimens were examined by immunohistochemistry. Both Bcl-2 and p53 were associated with malignant phenotype. Bcl-2 expression was more frequent in pT3 tumors (31% positive) than in pT2 tumors (5% positive, P = 0.001). p53 overexpression (found in 8%) was associated with high Gleason score (P = 0.03) and increased tumor growth fraction (Ki67 labeling index (LI); P = 0.017). Survival analysis showed that Bcl-2 expression (P = 0.03), high Ki67 LI (P = 0.018), high grade (P = 0.0037), advanced local stage (P = 0.0005), and positive lymph nodes (P = 0.026) were predictors of progression. The combined analysis of Ki67 LI and Bcl-2 allowed the distinction of three groups with different clinical outcome. Prognosis was best in Bcl-2-negative tumors with low Ki67 LI, worst in Bcl-2-positive tumors with high Ki67 LI, and intermediate in the remaining tumors (P = 0.03). These data suggest that altered expression of both Bcl-2 and p53 play a role in prostate cancer progression. Combined analysis of factors regulating both apoptosis and cell proliferation may be relevant in prostate cancer.
前列腺癌的临床病程高度多变，仅靠组织学标准无法令人满意地进行预测。为研究Bcl-2和p53过表达在前列腺癌中的预后意义，采用免疫组织化学方法对137例连续的根治性前列腺切除术标本进行了检测。Bcl-2和p53均与恶性表型相关。Bcl-2在pT3肿瘤中的表达更常见（31%阳性），高于pT2肿瘤（5%阳性，P = 0.001）。p53过表达（8%）与高Gleason评分（P = 0.03）和肿瘤生长分数增加（Ki67标记指数（LI）；P = 0.017）相关。生存分析显示，Bcl-2表达（P = 0.03）、高Ki67 LI（P = 0.018）、高级别（P = 0.0037）、局部晚期（P = 0.0005）和阳性淋巴结（P = 0.026）是进展的预测因素。Ki67 LI和Bcl-2的联合分析可区分出三组具有不同临床结局的患者。预后在Ki67 LI低的Bcl-2阴性肿瘤中最佳，在Ki67 LI高的Bcl-2阳性肿瘤中最差，其余肿瘤的预后居中（P = 0.03）。这些数据表明，Bcl-2和p53表达的改变在前列腺癌进展中起作用。调节细胞凋亡和细胞增殖的因素的联合分析可能与前列腺癌相关。
