Anton R C, Brown R W, Younes M, Gondo M M, Stephenson M A, Cagle P T
Department of Pathology, Baylor College of Medicine, and The Methodist Hospital, Houston, TX 77030, USA.
Hum Pathol. 1997 Sep;28(9):1079-82. doi: 10.1016/s0046-8177(97)90062-9.
The bcl-2 gene product inhibits apoptosis and is thought to participate in oncogenesis. Association of bcl-2 immunopositivity with improved prognosis of non-small cell lung cancers (NSCLC) is controversial. Although two studies have reported better survival in bcl-2-immunopositive NSCLCs, a third series has contradicted this finding. The authors studied a relatively larger case series involving 427 patients for whom detailed information on long-term follow-up was available to determine the prognostic significance of bcl-2 expression. The study included 252 adenocarcinomas (AC), 111 squamous cell carcinomas (SCC), and 64 large cell carcinomas (LC). After antigen retrieval, sections were immunostained using a monoclonal anti-bcl-2 antibody (1:60, Clone 124, Dako) and the avidin-biotin complex technique. Staining was scored as positive or negative and also on a semiquantitative scale as 0, low (<10%), moderate (10% to 75%), or extensive (>75%). Bcl-2 immunoreactivity was correlated with survival using the actuarial survival method, Kaplan-Meier method, and log-rank test and was not associated with statistically significant differences in survival for NSCLCs (P = .5537). Differences in survival remained insignificant even after NSCLCs were stratified for cell type, stage, or grade, singly or in combination. Therefore, using this method, bcl-2 immunopositivity does not appear to act as an independent prognostic indicator in NSCLCs.
bcl-2基因产物可抑制细胞凋亡，被认为参与肿瘤发生过程。bcl-2免疫阳性与非小细胞肺癌（NSCLC）预后改善之间的关联存在争议。尽管有两项研究报告称bcl-2免疫阳性的NSCLC患者生存率更高，但第三项研究系列却与这一发现相矛盾。作者研究了一个相对较大的病例系列，涉及427例患者，这些患者有详细的长期随访信息，以确定bcl-2表达的预后意义。该研究包括252例腺癌（AC）、111例鳞状细胞癌（SCC）和64例大细胞癌（LC）。经过抗原修复后，切片使用单克隆抗bcl-2抗体（1:60，克隆号124，Dako）和抗生物素蛋白-生物素复合物技术进行免疫染色。染色结果分为阳性或阴性，也采用半定量评分，分别为0分（低，<10%）、中度（10%至75%）或广泛（>75%）。采用精算生存法、Kaplan-Meier法和对数秩检验将bcl-2免疫反应性与生存率进行关联分析，结果显示NSCLC患者的生存率无统计学显著差异（P = 0.5537）。即使将NSCLC按细胞类型、分期或分级单独或联合分层后，生存率差异仍无统计学意义。因此，采用这种方法，bcl-2免疫阳性似乎不能作为NSCLC的独立预后指标。
