Expression and Prognostic Significance of bcl-2 in Epithelial Ovarian Tumors

Lee, D H; Kim, J H; Huh, J R; Kim, D J; Kim, Y M; Kim, Y T; Nam, C H; Mok, J E

Abstract

The expression of bcl-2 protein was studied in epithelial ovarian tumors by immunohistochemical analysis. We immunostained a series of epithelial ovarian tumors to assess the prevalence of bcl-2 expression in benign, borderline and malignant tumors respectively, and its clinicopathologic correlations and prognostic implications in malignant one. The study population comprised 108 patients with epithelial ovarian tumor, 10 with benign tumor, 24 with borderline one and 74 with malignant one respectively, treated at Asan Medical Center from June, 1989 to December, 1995. In benign tumors, there was none showing bcl-2 immunoreactivity. Among 24 borderline tumors, bcl-2 immunoreactivity, strictly confined to the neoplastic cells, were detected in 5 (20.8%) including 1 moderate expressor (10% to 50% immunoreactive tumor cells) and 4 high expressors (>50%). In malignant tumors, there were 11 low expressors (1% to 10%), 15 moderate expressors and 7 high expressors, resulting 44.6% (33/74) of positivity and the prevalence of bcl-2 immunoreactivity did not show association with any of the clinicopathologic variable such as FIGO stage, histologic type, tumor grade, residual tumor volume, ascites volume or CA 125 level after second chemotherapy. Life table analysis demonstrated that the presence or absence of bcl-2 expression did not show any difference in the patient`s survival (p=0.63 by Log-rank test), while FIGO stage (P=0.032), tumor grade (P=0.036), residual tumor volume (P=0.0091) and CA 125 level after second chemotherapy (P<0.036) did. Residual tumor volume (relative risk=2.06) and CA 125 level after second chemotherapy(relative risk=4.04) were revealed to be independent prognostic factors in Cox regression model. According to these results, we concluded that although bcl-2 has been strongly suggested to play a certain role in tumorigenesis, there seems to be no definite relationship between its expression and prognosis of patients with epithelial ovarian cancer.