Barbareschi M, Caffo O, Veronese S, Leek R D, Fina P, Fox S, Bonzanini M, Girlando S, Morelli L, Eccher C, Pezzella F, Doglioni C, Dalla Palma P, Harris A
Department of Histopathology, S. Chiara Hospital, Trento, Italy.
Hum Pathol. 1996 Nov;27(11):1149-55. doi: 10.1016/s0046-8177(96)90307-x.
Bcl-2 and p53 gene products (Bcl-2, p53) are important regulators of apoptosis and cell proliferation, and their immunohistochemical expression may help to identify high-risk breast cancer patients. The authors evaluated p53 and Bcl-2 immunoreactivity in 178 node-negative breast cancers (NNBC) with long-term follow-up (median, 60 months). Bcl-2 was seen in 111 (62%) cases, and was significantly associated with small tumor size, nonductal morphology, low tumor grade, estrogen-receptor (ER) positivity, and p53 negativity. p53 overexpression (ie, > 15% reactive nuclei) was observed in 31 (17%) cases, and was associated with lower age, large tumor size, ductal morphology, high tumor grade, negative ER status, and lack of Bcl-2 immunoreactivity. In univariate analysis, the variables associated with short relapse-free survival (RFS) were large tumor size (P = .002), high histological grade (P = .01), high mitotic count (P = .03), and high Nottingham prognostic index (NPI) (P = .0002). In multivariate analysis (final model), only the NPI was of independent prognostic value concerning RFS.
Bcl-2和p53基因产物（Bcl-2、p53）是细胞凋亡和细胞增殖的重要调节因子，其免疫组化表达可能有助于识别高危乳腺癌患者。作者评估了178例长期随访（中位随访时间60个月）的淋巴结阴性乳腺癌（NNBC）中p53和Bcl-2的免疫反应性。111例（62%）病例中可见Bcl-2，且其与肿瘤体积小、非导管形态、肿瘤低分级、雌激素受体（ER）阳性及p53阴性显著相关。31例（17%）病例观察到p53过表达（即>15%的反应性细胞核），其与年龄较小、肿瘤体积大、导管形态、肿瘤高分级、ER阴性及缺乏Bcl-2免疫反应性相关。在单变量分析中，与无复发生存期（RFS）短相关的变量有肿瘤体积大（P = 0.002）、组织学分级高（P = 0.01）、有丝分裂计数高（P = 0.03）及诺丁汉预后指数（NPI）高（P = 0.0002）。在多变量分析（最终模型）中，仅NPI对RFS具有独立的预后价值。
