Prognostic Value of the Expression of p53 and bcl-2 in Non-Small Cell Lung Cancer

Yang, Seok Chul; Yoon, Ho Joo; Shin, Dong Ho; Park, Sung Soo; Lee, Jung Hee; Keun, Joo Seob; Kong, Gu; Lee, Jung Dal

Abstract

BACKGROUND: Alteration of p53 tumor suppressor genes is most frequently identified in human neoplasms, including lung carcinoma. It is well known that bcl-2 oncoprotein protects eel]s from apoptosis. Recent studies have demonstrated that bcl-2 expression is associated with favorable prognosis for patients with non-small cell lung carcinoma. However, the precise biologic role of bcl-2 in the development of these tumors is sri]1 obscure. p53 and bcl-2 have important regulatory influence in the apoptotic pathway and thus their relationship is of interest in tumorigenesis, especially lung cancer. Purpose : The author investigated to know the prognostic significance of the expression of p53 and bcl-2 in radically resected non-small cell lung cancer. Method : 84 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from 1980 to 1994 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for p53 and bcl-2.
RESULTS
The histologic classification of the tumor was based on WHO criteria, and the specimens included 45 squamous cell carcinomas(53.6%), 28 adeonocarcinomas(33.3%) and 11 large cell carcinomas(13.1%). p53 immunoreactivity was noted in 47 cases of 84 cases (56.0%). bcl-2 immunoreactivity was noted in 15 cases of 84 cases (17.9%). The mean survival duration was 64.23 +/- 10.73 months in bcl-2 positive group and 35.28 +/- 4.39 months in bcl-2 negative group. The bcl-2 expression was significantly correlated with survival in radically resected non-small cell lung cancer patients(p=0.03). The mean survival duration was 34.71 +/- 6.12 months in p53 positive group and 45.35 +/- 6.30 months in p53 negative group(p=0.21). The p53 expression was not predictive for survival. There was no correlation between combination of the different status of p53 and bcl-2pression in our study.
CONCLUSIONS
The interaction and the regulation of new biologic markers, such as those involved in the apoptotic pathway, are complex. bcl-2 overexpression is a good prognostic factor in non-small cell lung cancer and p53 expression is not significantly associated with the prognostic factor in non-small co]1 lung cancer.