Geisler J P, Geisler H E, Wiemann M C, Zhou Z, Miller G A, Crabtree W
Department of Obstetrics and Gynecology, St. Vincent Hospital and Health Care Center, Indianapolis, Indiana, 46260, USA.
Gynecol Oncol. 1998 Nov;71(2):305-7. doi: 10.1006/gyno.1998.5192.
bcl-2 is a protein which prohibits programmed cell death. The purpose of this study was to determine whether bcl-2 staining was related to traditional prognostic factors and/or recurrence in patients with endometrial carcinoma.
One hundred twenty consecutively surgically treated patients with endometrial carcinoma had their tumors studied immunohistochemically for bcl-2 staining.
The mean follow-up of the patients was 53 months with a median of 56 months (range 30 to 68 months). bcl-2 staining was positive in 44.0% of patients with endometrioid carcinomas and in 23. 1% of patients with nonendometrioid carcinomas (P < 0.001). Increasing depth of invasion (P = 0.014), grade (P = 0.011), and FIGO stage (P = 0.018) were each correlated with decreasing bcl-2 staining. bcl-2 staining was positive in 44.1% of patients whose tumors showed no lymphovascular space invasion and in 11.1% of patients with lymphovascular space invasion (P < 0.001). Only 1 of 26 patients with recurrent disease had persistence of bcl-2 staining. Multivariate analysis revealed FIGO stage (P = 0.0051), histologic grade (P = 0.050), and lack of staining for bcl-2 (P = 0.012) to be independent predictors of recurrence.
bcl-2 persistence is more common in endometrioid than in nonendometrioid adenocarcinomas of the endometrium. It appears to be inversely correlated with the universally recognized prognostic factors of depth of invasion, histologic grade, and FIGO stage. Lack of bcl-2 persistence was an independent predictor of recurrence of disease. This group of patients continues to be followed to determine the role of bcl-2 persistence or lack of persistence as a predictor of 5-year survival of patients with endometrial carcinoma.
bcl-2是一种可抑制程序性细胞死亡的蛋白质。本研究旨在确定bcl-2染色是否与子宫内膜癌患者的传统预后因素和/或复发相关。
对120例连续接受手术治疗的子宫内膜癌患者的肿瘤进行bcl-2染色免疫组化研究。
患者的平均随访时间为53个月，中位数为56个月（范围30至68个月）。在子宫内膜样癌患者中，44.0%的患者bcl-2染色呈阳性，在非子宫内膜样癌患者中这一比例为23.1%（P<0.001）。浸润深度增加（P = 0.014）、分级（P = 0.011）和国际妇产科联盟（FIGO）分期（P = 0.018）均与bcl-2染色减少相关。在肿瘤无淋巴血管间隙浸润的患者中，44.1%的患者bcl-2染色呈阳性，而在有淋巴血管间隙浸润的患者中这一比例为11.1%（P<0.001）。在26例复发患者中，只有1例患者的bcl-2染色持续存在。多变量分析显示，FIGO分期（P = 0.0051）、组织学分级（P = 0.050）和bcl-2染色缺失（P = 0.012）是复发的独立预测因素。
bcl-2持续存在在子宫内膜样腺癌中比在非子宫内膜样腺癌中更常见。它似乎与浸润深度、组织学分级和FIGO分期等普遍认可的预后因素呈负相关。bcl-2持续存在的缺失是疾病复发的独立预测因素。这组患者仍在继续随访，以确定bcl-2持续存在或不存在作为子宫内膜癌患者5年生存率预测指标的作用。
