大肠腺瘤中细胞凋亡和增殖相关基因的表达与意义

目的：探讨大肠腺瘤中细胞凋亡和增殖相关基因的表达与意义。方法：用脱氧核糖核酸末端转移酶介导的TUNEL法缺口末端标记和免疫组化技术，检测45例大肠腺瘤组织细胞的原位凋亡（AI）、原位增殖（KI）及bcl-2、bax基因表达；并设立20例正常大肠粘膜和40例大肠癌为对照组，探讨细胞凋亡和细胞增殖在大肠癌早期发生中的作用。结果：正常结肠粘膜有少量的bcl-2、bax和ki－67（用KI表示）表达及少量凋亡细胞存在，但无异常表达。大肠腺瘤中bcl-2表达和KI明显增加，与正常组相比P均＜0.05；AI和bax表达轻度增加，与正常相比P＜0.05。bax与AI表达呈正相关（P＜0.01），bcl－2和bax及AI呈负相关。大肠癌中bcl-2表达和KI表达虽增加，但与腺瘤相比无统计学差异P＞0.05；大肠癌组织中AI和bax表达明显增加且与腺瘤组相比P＜0.05。结论：大肠癌发生早期即腺瘤中就有细胞凋亡调控基因及增殖基因的表达异常，且以抗凋亡基因bcl-2和增殖基因表达占主导地位。该基因的表达异常可能是大肠癌发生的一个较早期分子标志；细胞凋亡增加和bax表达异常可能是大肠癌发生的一个相对较早期分子生物学事件。早期检测抗细胞凋亡基因和增殖基因，有助于对大肠癌早期发生的评估。     

c-erbB-2 、bcl-2和p53在结直肠肿瘤中的表达及其临床意义

背景：c-erbB-2、bcl-2和突变型p53在结直肠腺瘤癌变过程中相互调节并发挥重要作用。目的：探讨结直肠肿瘤中c-erbB-2、bcl-2和D53蛋白的表达及其临床意义。方法：取42例结直肠腺癌、10例腺瘤和10例正常结直肠黏膜组织，以免疫组化方法检测其中c-erbB-2、bcl-2和p53蛋白的表达，分析其表达与腺癌临床病理特征的关系。结果：c-erbB-2、bcl-2和p53蛋白在腺癌、腺瘤和正常黏膜组织中的表达差异均有统计学意义（P〈0．05），bcl-2蛋白在腺癌组织中的表达低于腺瘤组织，c-erbB-2和p53蛋白在腺癌组织中的表达高于腺瘤和正常黏膜组织。c-erbB-2蛋白的表达随腺癌分化程度的降低而增高，bcl-2蛋白的表达随腺癌分化程度的降低而降低：c-erbB-2和p53蛋白的表达与淋巴结转移和Dukes分期呈正相关。腺癌组织中bcl-2与p53蛋白的表达呈负相关（rs=-0．301，P〈0．05）。结论：c-erbB-2与结直肠癌的进展、分化和转移相关。腺癌组织中p53高表达和bcl-2相对低表达提示两者可能参与了结直肠癌的发生、发展过程，bcl-2过表达可能在结直肠癌发生的早期起作用。     

大肠肿瘤细胞凋亡及相关基因表达的研究

为了探讨Ｂｃｌ－２和Ｐ５３蛋白在大肠肿瘤中的表达及与细胞凋亡的关系，用免疫组化方法观察了４５例大肠腺瘤和６１例大肠癌中Ｂｃｌ－２和Ｐ５３蛋白的表达。正常大肠粘膜中Ｂｃｌ－２和Ｐ５３均未见表达，而大肠腺瘤及大肠癌阳性率均较正常明显增加（Ｐ〈０．０１）。大肠腺瘤Ｐ５３表达随腺瘤大小增加而增加，其中≥２０ｍｍ组阳性率（７７．７８％）显著高于〈１０ｍｍ组（３５．００％，Ｐ〈０．０５）。Ｐ５３蛋白阳性率也随     

凋亡相关基因caspase-9,bax及bcl-2在大肠癌中的表达及其意义

目的探讨凋亡相关基因easpase-9,bax和bel-2在大肠癌中的表达及其在大肠癌发生、发展中的可能作用及相互关系。方法应用免疫组化S-P法检测20例正常大肠黏膜、48例大肠腺瘤及56例大肠癌中的caspase-9、bax和bcl-2蛋白的表达。用TUNEL 法检测细胞凋亡。结果正常大肠黏膜、大肠腺瘤和大肠癌中caspase-9的阳性表达率分别为5．00％、33．33％、64．29％,其表达率在三者间差异有显著性(P<0．01)。bax在三种组织中的表达率分别为5．00％、35．42％、62．50％,三者间差异有显著性(P<0．01)。bcl-2 在三者中的阳性表达率分别为15．00％、87．50％、60．71％,三者间差异亦有显著性(P<0．01)。caspase-9,bax和bcl-2的表达与大肠癌的分化程度有关(P<0．01),与Dukes分期无关(P>05)。正常大肠黏膜、腺瘤和大肠癌中细胞凋亡指数差异有显著性(P<0．01),细胞凋亡指数与肿瘤的分化程度有关(P<0．01),与Dukes分期无关(P>0．05)。caspase-9、bax和bcl-2的表达与细胞凋亡指数有密切联系 (P<0．01)。结论肿瘤早期阶段的细胞凋亡异常,可能是大肠癌的发病原因之一。bcl-2和bax通过调节caspase-9参与大肠癌的发生。     

survivin基因在大肠癌组织中的表达及其与bcl-2和p53基因的相关性探讨

目的 探讨survivin在大肠癌组织中的表达及其与bcl-2、p53基因表达的相关性。方法 应用免疫组织化学方法检测大肠腺癌组织中survivin及bcl-2、p53的表达,并与其在正常大肠黏膜、增生性息肉及腺瘤组织中的表达进行比较。结果survivin在正常大肠黏膜无表达,大肠腺瘤（62.5%）、大肠癌（70.9%）中survivin表达率显著高于正常大肠黏膜和增生性息肉（16.7%）（P〈0.01）;survivin表达与与肿瘤浸润深度和淋巴结转移明显相关（P均〈0.05）;大肠癌组织中bcl-2、p53基因与survivin基因表达显著相关（P均〈0.05）。结论 survivin参与了大肠癌的发生和发展,可作为判断预后的参考指标;抑癌基因p53的失活和bcl-2的表达上调与survivin基因的表达可能在大肠癌的发生、发展中起协调作用。     

大肠癌APC、β-catenin、E-cadherin和c-myc的表达及意义

目的探讨腺瘤性息肉蛋白(APC)、β-catenin、E-cadherin和c-myc在大肠癌发生、发展中的作用。方法采用免疫组化法检测正常大肠黏膜、大肠腺瘤、大肠腺瘤恶变及大肠癌组织中上述4种蛋白的表达情况。结果大肠癌和大肠腺瘤恶变APC阳性率显著低于大肠腺瘤和正常大肠黏膜(P<0.01)。大肠癌、大肠腺瘤恶变和大肠腺瘤β-catenin胞质/胞核异位表达率、c-myc阳性率显著高于正常大肠黏膜(P<0.01),大肠癌的β-catenin异位表达率显著高于大肠腺瘤(P<0.01)。大肠癌中β-catenin、E-cadherin膜表达缺失率显著高于大肠腺瘤和正常大肠黏膜(P<0.01)。大肠癌中β-catenin异位表达与c-myc阳性表达、E-cadherin阳性表达呈正相关,与APC阳性表达呈负相关。结论APC失表达和(或)β-catenin异位表达、c-myc过表达与大肠癌的发生相关,β-catenin、E-cadherin膜表达缺失与大肠癌的侵袭、转移有关。     

凋亡相关基因caspase-9、Bcl-2在大肠腺瘤和大肠癌中的表达及意义

目的 探讨凋亡相关基因caspase-9和Bcl-2在大肠腺瘤、大肠癌中的表达及意义。方法 应用免疫组化S-P法检测56例大肠癌、48例大肠腺瘤及20例正常大肠黏膜中的caspase-9和Bcl-2蛋白的表达。用TUNEL法检测细胞调亡。结果 正常大肠黏膜、大肠腺瘤和大肠癌中caspase-9的阳性表达率分别为5.00％、33.33％、64.29％,其表达率在三者间有显著性差异(P<0.01)。Bcl-2在正常大肠黏膜、大肠腺瘤和大肠癌中的阳性表达率分别为15.00％、87.50％、60.71％,三者间亦有显著性差异(P<0.01)。caspase-9,Bcl-2的表达与肿瘤的分化程度有关(P<0.01),与Dukes分期无关(P>0.05)。正常大肠黏膜、腺瘤和大肠癌中凋亡指数有显著性差异(P<0.01),凋亡指数与肿瘤的分化程度有关(P<0.01),与Dukes分期无关(P>0.05)。caspase-9,Bel-2的表达与凋亡指数有密切联系(P<0.01)。结论 在大肠癌形成过程中,caspase-9,Bcl-2参与了肿瘤形成的共同通道;肿瘤早期阶段细胞凋亡的异常和增生过度,楞能是大肠癌的发病原因之一。     

P53、malat1、ki-67和β-catenin基因mRNA检测在大肠癌分子诊断中的意义

目的:初步研究多个大肠癌相关基因p53、malat1、ki-67和β-catenin在大肠癌分子诊断中的意义.方法:收集手术切除的新鲜大肠癌组织标本47例、大肠腺瘤组织标本13例,以及分别和大肠癌、大肠腺瘤对应的正常大肠黏膜组织标本53例,用实时荧光定量RT-PCR方法检测各基因的Ct值.结果:p53、malat1在大肠癌组表达量均高于大肠腺瘤组(P=0.026,P=0.034),但是p53在正常大肠黏膜组、大肠腺瘤组和大肠癌组中表达依次增高,而malat1在大肠腺瘤组、正常大肠黏膜组和大肠癌组中表达量依次增高,大肠腺瘤组mRNA表达最低.ki-67在大肠癌组的表达量是正常黏膜组表达量的1.42倍(P=0.007).β-catenin基因在三组间的表达差异无统计学意义.各基因的表达量均和大肠癌的分期无关.经ROC曲线分析,p53的曲线下面积是0.755(P<0.05),在大肠腺瘤组和大肠癌组的最佳Cut-off值分别是2.585、3.215,malat1的曲线下面积是0.748(P<0.05),在大肠腺瘤组和大肠癌组的最佳Cut-off值分别是0.925、1.395;二元Logistic回归分析,p53和malat1进入回归模型(P<0.05).联合检测p53和malat1在大肠腺瘤组和大肠癌组的ROC曲线下面积为0.785(P=0.01),在大肠腺瘤组的和大肠癌组的最佳Cut-off值分别是0.750、0.790.p53和malat1联合检测的ROc曲线下面积均高于单独检测的ROC曲线下面积.结论:p53和malat1在大肠癌的分子诊断中有一定的应用价值.可为鉴别大肠腺瘤和大肠癌提供有效的参考;和单独检测相比,二者联和检测的准确性高于单独检测的准确性.     

大肠癌和大肠腺瘤COX-2和Bcl-2的基因表达及其意义

目的　探讨COX 2及Bcl 2基因在大肠癌和大肠腺瘤组织中的表达及其意义。方法　应用免疫组化ABC法检测 2 8例大肠癌、2 8例大肠腺瘤和 10例正常黏膜中COX 2及Bcl 2表达 ,应用TUNEL法检测细胞凋亡。结果　在大肠癌、大肠腺瘤及正常黏膜中COX 2的阳性表达分别为 82 1%、85 7%和 0 0 %。Bcl 2的阳性表达分别为 75 0 %、78 6%和 2 0 0 %。大肠癌与腺瘤的COX 2及Bcl 2表达均无显著性差异 (P >0 0 5) ,但均显著高于正常黏膜 (P <0 0 1)。大肠癌中凋亡指数明显高于大肠腺瘤 (χ2 =8 80 ,P <0 0 5) ,COX 2和Bcl 2的表达均与大肠腺瘤及大肠癌的细胞凋亡指数呈显著负相关 (腺瘤P <0 0 1;癌P <0 0 5) ,两者均与临床病理特征无相关性 (P >0 0 5) ,大肠癌高、中、低分化各组间及不同Dukles分期 (A、B期和C、D期 )各组间凋亡指数无显著性差异 (P>0 0 5)。结论　COX 2和Bcl 2在大肠腺瘤及大肠癌中表达增强 ,从而抑制了细胞凋亡 ,在大肠腺瘤恶变及大肠癌的发生和发展过程中起到重要作用     

转化生长因子TGF-α和p53基因在大肠癌组织中的表达及意义

目的探讨TGF-α和p53在大肠癌发生、发展中的作用。方法采用免疫组化法检测155份大肠癌组织（大肠癌组）、25份大肠腺瘤组织（腺瘤组）及25份正常肠组织（对照组）中TGF-α、p53表达;分析TGF-α、p53表达与大肠癌临床病理特征的关系。结果对照组、腺瘤组及大肠癌组TGF-α表达阳性率分别为0、20%、37.4%,三组间比较无明显差异;p53表达阳性率分别为0、0、51.0%,大肠癌组与对照组、腺瘤组比较,P均〈0.05。大肠癌组p53和TGF-α同时阳性者5年生存率为1.9%,明显低于单一阳性表达者（28.3%）及两者均阴性者（69.8%）,P均〈0.05。结论 TGF-α和p53在大肠癌组织中呈高表达,在大肠癌发生、发展中起促进作用;检测二者水平对判断大肠癌恶性程度和估计预后有一定临床价值。     

Immunoreactive Transforming Growth Factor β-1, Its Receptor,bcl-2 Protein,and p53 Protein in Colorectal Adenomas

Abstract: Immunoreactive transforming growth factor-β1 (TGF-β1), its receptor (TGFR), bcl-2 protein, and p53 protein were stained in 47 samples of normal colonic mucosa and 33 samples of colorectal adenoma, with the aim of exploring an alternate, novel pathway of colorectal tumorigenesis. There was no difference in the percentage of cells positive for TGF-β1 immunoreactivity between normal mucosae and adenomas. TGFR immunoreactivity was detected in a significantly higher percentage of normal mucosae than of adenomas (p ±0.05). Bcl-2 protein and p53 protein immunoreactivities were detected in a significantly higher percentage of adenomas than of normal mucosae (p ±0.01). Expression of these immunoreactive proteins did not correlate with any of the clinicopathological features of adenomas, except for a significant negative correlation between TGFR expression and large tumor size (p±0.05) and a positive correlation between p53 protein expression and the grade of dysplasia (p±0.05). These findings indicate that (1) TGF-β1 plays little role in the tumorigenesis of colorectal adenomas, (2) TGFR is lost in most adenomas during tumorigenesis, (3) bcl-2 protein plays an important role in transformation of normal mucosa into adenoma, and (4) p53 protein is involved in the very early phase of malignant transformation from adenoma to carcinoma.     

Immunohistochemical expression of bcl-2, bcl-xL, bax, p53 proteins in gastric adenoma and adenocarcinoma]

BACKGROUND/AIMS: The aim of this study was to investigate the immunohistochemical expression of bcl-2, bcl-xL, bax, and p53 proteins according to the pathological parameters such as grade of dysplasia, histological type, depth of invasion, lymph node metastasis, and TNM stage in the gastric adenoma and gastric adenocarcinoma. METHODS: Immunohistochemical staining using monoclonal bcl-2, bcl-xL, bax, p53 antibodies were performed on paraffin embedded specimens from forty-one gastric adenomas and 100 gastric adenocarcinomas. RESULTS: The expression rate of bcl-2 was higher in adenomas (34.2%), especially in high grade dysplasia (52.4%), than adenocarcinomas (2.0%). The expression rate of bcl-xL was higher in adenocarcinomas (55.0%) than adenomas (22%). The expression rate of the bax was higher in adenocarcinomas (58.0%) than adenomas (14.6%). In the adenocarcinoma, the bax expression was significantly related with the depth of invasion, lymph node metastasis, and TNM stage. The expression rate of p53 was higher in adenocarcinomas (64.0%) than adenomas (14.6%). CONCLUSIONS: Bcl-2 protein would be related with the development of gastric adenoma, especially with high grade dysplasia. Bcl-xL and p53 proteins would be involved in the development of relatively early stage of gastric adenocarcinoma but not in tumor progression. Bax protein would be involved in the development of gastric adenocarcinoma and related with depth of invasion, lymph node metastasis, and TNM stage.     

Expression of P53 oncoprotein in benign and malignant lesions of large bowel

AIM: To investigate the expression of P53 oncoprotein in benign and malignant lesions of the large bowel as well as the relationship between p53 expression and clinicopathological factors. METHODS: Immunohistochemistry was used to detect P53 protein in large bowel tissues of 146 cases with benign and malignant lesions. RESULTS: All normal large bowel mucosae and non-neoplastic polyps were negative for P53 protein. However, the positive rates of P53 protein in adenomas, paracancerous mucosae and carcinomas were 18.18% (2/11), 13.21% (7/53) and 42.11% (32/76), respectively. The P53 expression in both adenomas and paracancerous mucosae presented only weak staining, whereas 75% of p53 positive cancers displayed very intense staining (++ or +++). The rates of P53 protein detection in poorly differentiated carcinoma and mucous carcinoma were 63.64% (7/11) and 62.5% (10/16), respectively, which were much higher than that of well/moderately differentiated carcinomas (30.16%, 15/40) (p < 0.05), and the carcinomas with marked positive p53 expression were more likely to penetrate the bowel wall and metastasize to lymph nodes (p < 0.05). However, no relationship between p53 expression and massive type, tumor size, location, Dukes stage or 3-year survival was found in this study. CONCLUSION: P53 gene mutation and overexpression are common in colorectal cancers, and seem to be associated with histological type, progression and lymph node metastasis of colorectal cancer.     

Epithelial markers of colorectal carcinogenesis in ulcerative colitis and primary sclerosing cholangitis

AIM:To evaluate the expression of epithelial markers of colorectal carcinogenesis in patients with long-term ulcerative colitis(UC) and primary sclerosing cholangitis(PSC) before and after transplantation.METHODS:Eight patients with UC and PSC prior to liver transplantation(PSC-UC),22 patients with UC after liver transplantation for PSC(OLT),9 patients with active ulcerative colitis without PSC(UCA),7 patients withUC in remission(UCR) and 10 controls(N) underwent colonoscopy with multiple biopsies.Specimens were analysed histologically and semi-quantitatively immunohistochemically for p53,Bcl-2 and cyclooxygenase-2(COX-2) markers.Statistical analysis was performed by Kruskal-Wallis and Fisher’s exact tests.RESULTS:PSC-UC had a statistically significantly higher expression of p53 in the nondysplastic mucosa as compared to OLT,UCA,UCR and N(P < 0.05).We also found a statistically significant positive correlation between the incidence of PSC and the expression of p53(P < 0.001).UCA had a higher p53 expression as compared to UCR.OLT had a significantly lower expression of p53 as compared with PSC-UC(P < 0.001).Bcl-2 had a significant higher bcl-2 expression as compared with controls.No difference in COX-2 expression between PSC-UC,UCR and UCA was found.UCA had higher COX-2 expression as compared to UCR.We also found a statistically significant positive correlation between the expression of COX-2 and p53.Patients after liver transplantation for PSC had a statistically significantly lower expression of the p53 compared with PSCUC(P < 0.001).PSC-UC had the same inflammatory endoscopic activity as OLT and UCR when evaluated with the Mayo score.CONCLUSION:Our study shows that the nondysplatic mucosa of UC patients with PSC is characterised by a higher expression of the tumour suppressor gene p53,suggesting a higher susceptibility of cancer.This p53 overexpression correlates with the presence of PSC whilst it is not present in patients with UC after liver transplantation for PSC.     

P53 protein immunohistochemical expression in colonic adenomas with and without associated carcinoma

Objectives: P53 protein immunohistochemical (IHC) expression was investigated in a series of colonic adenomas and carcinomas to determine the p53 immunohistochemical expression of adenomas in general compared with carcinomas, the difference in staining pattern between adenomas with associated carcinoma and those without associated carcinoma, and the difference in p53 staining in the usual adenomas (low-grade dysplasia) compared with those harboring high-grade dysplasia.
Methods: The study involved a series of 20 adenomas without concurrent carcinoma (group 1 adenoma), 29 adenomas with concurrent carcinoma (group 2 adenoma), and 20 carcinomas. Sections of the paraffin-embedded tissues were stained with DO-7 p53 monoclonal antibody after microwave antigen-retrieval method. Cases with nuclear staining in ≥ 20% of the tumor cells were considered positive.
Results: Analysis of results showed that 65% of carcinomas and 37% of all adenomas were reactive with p53 IHC staining (   p = 0.03  ). With respect to the adenomas, 30% of group 1 and 41% of group 2 adenomas were reactive for p53 protein (   p = 0.42  ).
Conclusions: Our data demonstrate a statistically significant higher p53 expression rate in colonic carcinomas than in adenomas, and that adenomas with concurrent carcinomas are more frequently p53 positive than those without concurrent carcinoma, but this was not statistically significant. Also, p53 expression is more frequent and intense in adenomas with high-grade dysplasia (10/20, 50%) than in ordinary adenomas with low-grade dysplasia (8/29, 28%), which suggests a strong correlation between the degree of dysplasia in colonic neoplasia and p53 expression pattern.     

Overexpression of p53 protein and histologic grades of dysplasia in colorectal adenomas

PURPOSE: To clarify the relation between tumor-suppressor gene p53 expression and histologic grades of dysplasia in colorectal adenomas, we performed immunohistochemical analysis in a series of 59 colorectal polyps and 40 advanced carcinomas. METHODS: Adenomatous polyps were stained by hematoxylin and eosin and classified into mild, moderate, and severe dysplasia (intramucosal carcinoma), according to the World Health Organization's classification. RESULTS: p53 was positive in 7.1 percent (2/28) of mild, 29.4 percent (5/17) of moderate, and 62.5 percent (5/8) of severe dysplasia. In submucosal and advanced carcinomas, positivity rates were 75 percent (3/4) and 47.5 percent (19/40), respectively. Different staining patterns were found, according to grades of dysplasia. In the adenomas with mild or moderate dysplasia, a few focal crypts showed localized p53-positive staining. Adenomas with severe dysplasia had two different staining types. One was a focal staining type as shown in mild or moderate dysplasia; the other was a diffuse staining type, in which glands with mild or moderate dysplasia, surrounding severe dysplasia area, were also stained. Submucosal and advanced carcinomas showed a strong positive staining in cancer cells only. CONCLUSIONS: Overexpression of p53 protein in adenomas with mild or moderate dysplasia and existence of two types of expression in adenomas with severe dysplasia were observed. These facts suggested the possible existence of different pathways in the adenoma to carcinoma progression.     

p53 and bcl-2 protein expression in rectosigmoid adenomas

Objective: The aim of this study was to evaluate whether p53 or bcl-2 protein expression in rectosigmoid adenomas is associated with histological characteristics of the adenomas and with presence of synchronous advanced proximal neoplasms.
Methods: Seventy-six average-risk patients who underwent total colonoscopy and had rectosigmoid adenoma(s) were studied. An adenoma was considered advanced if villous histology and/or severe dysplasia and/or diameter >1 cm were present. p53 And bcl-2 protein expression was immunohistochemically examined using specific monoclonal antibodies.
Results: p53 Protein was detected in 43% and bcl-2 in 93% of the 76 rectosigmoid adenomas. Advanced compared with nonadvanced adenomas were significantly more frequently p53-positive (28 of 44 or 63.6% vs five of 32 or 15.6%,   p < 10⁻⁴  ) or had a bcl-2 score of 12 (20 of 44 or 45.5% vs five of 32 or 15.6%,   p = 0.007  ). Proximal advanced neoplasms were mainly found in patients with rectosigmoid adenomas positive for p53 and with a bcl-2 score of 12 (six of 17 or 35.3% vs 2/59 or 3.4%, OR: 15.6,   p = 0.001  ) and in particular in those with advanced rectosigmoid adenomas positive for p53 and with a bcl-2 score of 12 (six of 13 or 46.2% vs two of 31 or 6.5%, OR: 12.4,   p = 0.007  ).
Conclusion: p53 Expression and bcl-2 protein overexpression in rectosigmoid adenomas are associated with advanced histology and a high risk of synchronous advanced proximal colon neoplasm.     

Potential Role of Apoptosis and Apoptotic Regulatory Proteins in Colorectal Neoplasia: Correlations with Clinico-Pathological Parameters and Survival

An imbalance between apoptotic and proliferative processes is believed to underlie colorectal neoplasia. We evaluated the expression of bcl-2, p53, mdm2 proteins, and apoptosis in colorectal neoplasms, as well as their correlation with clinico-pathological parameters, using image analysis. Biopsies from 46 colorectal cancers, 121 adenomas, and 25 controls were studied using monoclonal antibodies against p53, bcl-2, mdm2 and the terminal deoxynucleotidyl-transferase-mediated dUTP nick end labeling (TUNEL) method for apoptosis. P53 and bcl2 protein expression was higher in adenomas ≥1 cm (P < 0.03) and tubulovillous-villous adenomas (P < 0.03), and correlated with dysplasia (P < 0.03). In Cox regression analysis, Dukes’ stage was the most significant independent prognostic indicator of a worse survival (P < 0.019), whereas when stage was eliminated, bcl-2 expression was also a powerful predictor for bad prognosis (P = 0.02). In conclusion, both bcl-2 and p53 immunohistochemical profiles may be useful adjuncts in detecting adenomas with a malignant potential, whereas bcl-2 could be used in combination with Dukes’ stage as a predictor of prognosis in colorectal cancer.