Clinicopathologic Analysis of Fas, Fas Ligand, and Other Biomarkers in Locally Advanced Breast Carcinoma

Abstract: Fas and Fas ligand (FasL) mediate T-lymphocyte cytotoxicity and may also induce physiologic apoptosis in breast epithelium associated with menstruation and cessation of lactation. Altered expression may thus be associated with breast carcinoma progression, chemotherapy response, or outcome. We performed a clinicopathologic analysis of immunohistochemical staining for Fas and FasL, as well as bax, bcl-2, glutathione-s-transferase, HER-2 (c- erb B-2), Ki67, P-glycoprotein, p53, and hormone receptors in pretreatment breast biopsies from 34 patients with locally advanced or limited stage IV breast carcinoma who received preoperative (neoadjuvant, primary) chemotherapy followed by lumpectomy or mastectomy. Neoplastic cells expressed Fas in 44% and FasL in 85% of pretreatment biopsies. Fas immunostaining was more frequent in tumors with larger size (p = 0.02) and pretreatment metastases (p = 0.03). Combined Fas and p53 staining correlated with pathologic complete response (4 of 5 CR versus 6 of 29 other, p = 0.02), as did combined p53 and lack of FasL staining (2 of 5 CR versus 0 of 29 other, p = 0.02), but individually Fas, p53, and lack of FasL immunostaining demonstrated only trends to correlation with CR (p = 0.13–0.15). No other biomarkers correlated with chemotherapeutic response. Neither FasL nor Fas expression was associated with the degree of peritumoral lymphocytic infiltration, or with expression of the other biomarkers. Recurrence was more frequent in Fas-expressing tumors (recurrent cases 7 of 10 Fas positive versus nonrecurrent 8 of 24 Fas positive, p = 0.07). In this patient group, Fas expression is associated with aggressive tumor behavior. Biomarker immunostaining correlates weakly with pathologic response to preoperative chemotherapy, in keeping with complex or heterogeneous tumor-drug interactions.     

MIB-1 Proliferation Index in Ductal Carcinoma In Situ of the Breast: Relationship to the Expression of the Apoptosis-Regulating Proteins bcl-2 and p53

Tumor growth is the net result of cell proliferation and cell death. To investigate the relationship between these phenomena in ductal carcinoma in situ (DCIS), we studied proliferation index (PI) in DCIS in relation to the expression of two proteins involved in the regulation of cell death, bcl-2 and p53. Thirty-nine consecutive cases of DCIS were studied. PI was determined using immunolabeling with the monoclonal antibody MIB-1. The proportion of MIB-1-positive nuclei among 500 tumor cell nuclei was determined for each case and constituted the PI. All cases were also assessed immunohistochemically for bcl-2 and p53 protein expression. DCIS cases were graded using the criteria of Holland et al. PI ranged from 0 to 57% (mean 11.2%, median 4.6%). PI was significantly lower in well-differentiated and intermediately differentiated DCIS cases (mean 7.3% and 4.8%, respectively) than in poorly differentiated lesions (mean 24%, p = 0.01). PI was significantly lower in bcl-2-positive cases than in bcl-2-negative cases (mean PI for bcl-2-positive cases 6% and for bcl-2-negative cases 26%, p = 0.01). PI was higher in lesions expressing the p53 protein than in p53 negative cases (19% versus 8.3%), but this difference did not reach statistical significance. PI was also examined in relation to combinations of bcl-2 and p53 expression. Twenty-five of the DCIS lesions (64%) showed the bcl-2-positive/p53-negative phenotype which is similar to that seen in normal breast tissue and benign lesions and can be considered the "physiologic" combination. Among these cases the mean PI was 6.4%. In contrast, 14 cases showed "aberrant" combinations of bcl-2 and p53 expression suggesting dysregulated control of apoptosis. Among these cases the mean PI was 19.6% (p = 0.03). The highest mean PI was in cases with the bcl-2-negative/p53-positive phenotype (PI = 29.7%). DCIS lesions with the physiologic bcl-2-positive/p53-negative phenotype have low PI. In contrast, DCIS lesions with "aberrant" bcl-2/p53 phenotypes have high PI. This combination may favor tumor growth and progression in DCIS.     

The expression of oncoproteins in transitional cell carcinoma: its correlation with pathological behavior,cell cycle and drug resistance

OBJECTIVE: To investigate the relationship of oncoproteins with histological grade, tumor stage, cell cycle and multidrug resistance (MDR) in bladder cancer. METHODS: The expression of various oncoproteins (p21, EGFR1, erbB-2, c-jun, c-myc, bcl-2, Bax) and suppressor gene products (WT-1, RB gene, p53) was studied in normal urothelium, transitional cell carcinoma (TCC) cell lines and their MDR sublines by using specific antibodies and an indirect immunofluorescence flow-cytometric method. RESULTS: The total increased rate of measured oncoproteins in TCC cell lines was 62.7%. There was no difference in the expression rate of oncoproteins between low-grade/stage TCC cell lines and high-grade/stage TCC cell lines. All of these TCC cell lines have aneuploidy and increased proliferative activity in the cell cycle, but a correlation with oncoprotein expression was not seen. They had a low expression rate of c-myc, Bax and RB gene when compared to normal urothelium. On the contrary, the expressions of p21, EGFR1, erbB-2, bcl-2, WT-1 and p53 oncoproteins were significantly higher than in normal urothelium (p < 0.05). A long-term cultured MDR subline of TCC8702 (TCC8702/ADR1000) demonstrated a generally decreasing expression of oncoproteins in addition to p53. CONCLUSIONS: The p21, EGFR1, erbB-2, bcl-2, WT-1 and p53 oncoproteins were increased in TCC cells compared to normal urothelium. Oncoprotein expression is related to tumorigenesis of TCC cells, but no correlation was seen between the incidence and tumor differentiation and cell cycle. These oncoproteins decreased gradually in the process of generation of MDR in addition to p53. It indicates that the p53 oncogene is closely related to the acquired MDR of TCC cells.     

5-氟尿嘧啶诱导直肠癌HR8348细胞凋亡作用的研究

目的　探讨 5 氟尿嘧啶 (5 fluorouracil ,5 FU )体外诱导直肠癌HR83 48细胞凋亡的作用及细胞凋亡与bcl 2、bcl xl、bax及 p5 3表达的关系。 方法　经 5 FU处理HR83 48细胞 2 4h后 ,用甲基绿 派若宁染色法和TUNEL法检测细胞凋亡情况 ,并用SP免疫组织化学法检测HR83 48细胞中bcl 2、bcl xl、bax和 p5 3的表达。 结果　HR83 48细胞经 5 FU作用 2 4h后 ,细胞凋亡指数 (AI)明显高于对照组 ,差异有显著性意义 (P<0 .0 1)。 5 FU作用不同时相bcl 2的表达评分结果与对照组比较差异均无显著性意义 ;不同时相bcl xl的表达评分结果与对照组比较稍降低 ;而bax的表达评分结果随时间延长明显增加 ,2 4h、3 6h的表达评分结果明显高于对照组 (P<0 .0 1) ,而 p5 3在 5 FU组和对照组各时相均未见表达。结论　 5 FU具有诱导HR83 48细胞凋亡的作用 ;5 FU可能通过上调bax的表达并改变bax/bcl xl的比值而诱导HR83 48细胞凋亡。     

肾细胞癌中bcl-2、p53、增殖细胞核抗原表达与细胞增殖和凋亡

目的 探讨肾细胞癌(RCC)中bcl—2、p53、增殖细胞核抗原(PCNA)表达与细胞增殖、凋亡及病理参数之间的关系。方法 应用链霉亲和素辣根过氧化物酶(SABC)法分析34例RCC标本中bcl—2、p53和PCNA蛋白的表达，应用末端脱氧核苷酸转移酶介导的脱氧三磷酸尿苷苦(dUTP)缺口末端标记(TUNEL)法检测细胞凋亡。结果 34例RCC标本中，15(44．1％)例bcl-2阳性表达，表达阳性率与增殖指数(PI)、凋亡指数(AI）及RCC病理学参数无关；仅有3例p53表达阳性；PI为6．0％--24．0％(平均为12．3％)，AI为2．0％--8．0％(平均为5．4％)；PI与肿瘤分级、分期密切关系，AI与肿瘤分级有明显关系。结论 明显增高的PI和AI与肿瘤恶性表型有关，提示在RCC中肿瘤细胞过度增殖伴有频繁的凋亡发生。     

Apoptotic and proliferative indexes in esophageal cancer: predictors of response to neoadjuvant therapy [corrected].

Altered expression of the genes that control apoptosis and proliferation may influence the response of cancer cells to cytotoxic agents. The primary aim of this study was to determine the role of the novel antiapoptotic and cell cycle gene, survivin, in apoptotsis and proliferation in esophageal cancer and to evaluate whether the survivin, p53, and bcl-2 status were able to predict a patient's response to neoadjuvant therapy. A total of 104 patients with esophageal tumors were studied. Tumor tissue was immunostained for survivin, p53, and bcl-2 proteins. Proliferative and apoptotic activity was measured using ki-67 immunohistochemical analysis and the TUNEL method, respectively. Forty-eight patients whose pretreatment biopsies were analyzed received neoadjuvant chemoradiation therapy or chemotherapy followed by surgery. Outcome was graded as a complete response, a partial response, or no response according to the results of histologic examination and CT imaging. Expression of survivin was found to correlate significantly with the proliferative index but not the apoptotic index. Patients who received neoadjuvant treatment were more likely to achieve a complete response if their tumors had high proliferative activity, and p53 positive tumors were more likely to contain residual tumor after treatment. In conclusion, survivin expression appears to foster proliferative activity in esophageal cancer, and tumors with a high proliferative index or a functioning p53 gene are more responsive to neoadjuvant chemoradiation therapy.     

Expression of bcl-2, p53 oncoprotein, and proliferating cell nuclear antigen in renal cell carcinoma

OBJECTIVES: This study was designed to examine the immunohistochemical expression of bcl-2, p53, and proliferating cell nuclear antigen (PCNA) and the relation of this expression to clinicopathological characteristics and prognosis in renal cell carcinoma (RCC). METHODS: The expression of bcl-2, p53 protein, and PCNA was studied by immunohistochemical methods in paraffin-embedded nephrectomy specimens from 53 patients whose clinicopathological data had already become clear. RESULTS: The expression of the bcl-2 protein was recognized in 34 cases (64%); the expression of the p53 protein, however, was seen in only 1 case. Bcl-2 positivity was not associated with any pathological parameters or prognosis. If the percentage of PCNA-positive cancer cells as compared to the total amount of cancer cells was defined as a labeling index (LI), a high PCNA LI number correlated significantly with a high T category, high grade, venous invasion, and shortened survival. Among the conventional pathological parameters, the T category, nuclear grade, and venous invasion had the most significant effect on prognosis. A multivariate analysis in the parameters of PCNA, T category, nuclear grade, and venous invasion demonstrated that only nuclear grade had a significant effect on prognosis. CONCLUSIONS: The inhibitory effect of the bcl-2 gene on apoptosis related to tumor development is not clear, and the expression of the p53 protein is uncommon in RCC. PCNA seems to be a good objective and quantitative marker of the biological malignant potential in RCC, although the assessment of malignant potential in combination with conventional pathological parameters is indispensable.     

苦参碱对增生性瘢痕成纤维细胞凋亡及相关调控蛋白表达的影响

目的　研究苦参碱 (matrine,Mat)对增生性瘢痕成纤维细胞 (fibroblast,FB)凋亡及相关调控蛋白表达的影响。方法　于 2 4只新西兰白兔耳部腹侧面制作增生性瘢痕模型。所有动物随机分为Mat组和对照组 (每组 12只 ) ,分别采用Mat(5 0 g/L)和等渗盐水于各组兔耳瘢痕处行局部封闭注射 ,1次 / 4d。用药 2、4、6、8、12周后 ,采用DNA切口末端标记技术 (TUNEL)检测各组增生性瘢痕FB的凋亡细胞数量 ,利用免疫组织化学方法检测凋亡相关调控蛋白 p5 3、bcl 2、bax的表达。 结果与对照组比较 ,用药 2、4、6、8、12周后 ,Mat组FB凋亡数量均明显增加 (P <0 .0 5 ) ,bax表达明显增强 ,p5 3、bcl 2表达明显减弱 ,瘢痕逐渐趋于平复。　结论　Mat可促进兔耳增生性瘢痕FB的凋亡 ,使凋亡相关调控蛋白bax表达上调 ,p5 3、bcl 2表达下调     

乳腺癌病理生物学特性与多肿瘤基因表达的关系

目的 观察多肿瘤基因在乳腺癌组织中的表达,探讨其与乳腺癌病理生物学特性的关系.方法 采用免疫组织化学SP染色法对120例乳腺癌组织中多肿瘤基因的表达进行检测[雌激素受体(ER)、孕激素受体(PR)、表皮生长因子受体(C-erB-2)、p53、转移抑制基因(mn23)、bcl-2、增殖细胞核抗原(PCNA)、多药耐药蛋白(MRP)],分析其与乳腺癌病理生物学特性的关系.结果 p53、bcl-2的表达在不同乳腺癌激素受体状态中差异有统计学意义,且与ER、PR的表达有显著相关性:p53在ER(-)、PR(-)的乳腺癌中呈现高表达,在ER(+)、PR(+)的乳腺癌中呈现低表达(P<0.01);而bcl-2则相反(P<0.01).bcl-2的表达与月经状态有关,在绝经前乳腺癌组织中的表达明显高于绝经后乳腺癌(P<0.01).PCNA的表达与肿瘤的大小相关,在直径较大的肿瘤(>3 cm)中的表达显著高于直径较小的肿瘤(≤3 cm,P<0.01).结论 p53、bcl-2的表达与ER、PR的状态相关,可作为判断乳腺癌生物学特性和预后的重要指标.     

Elevated Levels of Apoptosis Regulator Proteins P53 and BCL-2 are Independent Prognostic Biomarkers in Surgically Treated Clinically Localized Prostate Cancer

Purpose

The tumor suppressor gene (TSG) p53 and the proto-oncogene bcl-2 have been shown to be involved in the regulation of cell growth and apoptosis and have been implicated in hormone refractory prostate cancer (PC) and poor prognosis. The goal of this study was to determine the clinical utility of the presence of p53 and bcl-2 immunohistochemical (IHC) protein in the primary tumor as predictors of disease progression following radical prostatectomy (RP).

Materials and Methods

The expression of p53 and bcl-2 was evaluated in archival paraffin-embedded RP specimens from 175 patients followed from 1 to 9 years (mean = 4.6 years) and correlated with stage, grade, race and serologic (PSA) recurrence following surgery.

Results

Overexpression of bcl-2 was noted in 47 of 175 (26.9 percent) patients; these patients had a significantly higher 5-year failure rate than those who did not overexpress bcl-2 (67.0 percent versus 30.7 percent). Expression of p53 was noted in 114 of 175 (65.1 percent) patients with a 5-year failure rate of 51.1 percent compared with a 5-year failure rate of only 22 percent in p53 negative patients. When expression rates for p53 and bcl-2 were combined, the 5-year failure rate was 75.3 percent. Conversely, when both p53 and bcl-2 IHC staining were negative, the 5-year failure rate was 20.4 percent. Univariate Kaplan-Meier analysis showed a statistically significant difference between p53 and bcl-2 positive and negative patients (p less than 0.001). Multivariate Cox Regression Analysis with backward elimination controlling for age, race, stage and grade showed both p53 (p = .0185) and bcl-2 (p = .044) to be independent predictors of disease-free survival.

Conclusion

p53 and bcl-2 appear to be important biomarkers that predict recurrence in clinically localized PC after RP.     

Influence of p53 and bcl-2 on chemosensitivity in benign and malignant prostatic cell lines

The administration of cancer chemotherapeutic agents results in an increase in the apoptotic cells in the tumor: therefore, it has been assumed that anticancer drugs exhibit their cytotoxic effects via apoptotic signaling pathways. Characteristics that confer sensitivity to drug-induced apoptosis are, a functional p53 protein and expression of the apoptosis-promoting protein, bax. The role of p53 and bax/bcl-2 in drug-induced apoptosis was assessed in six prostate cell lines, 1532T, 1535T, 1542T, 1542N, BPH-1 and LNCaP using TD(50) concentrations of etoposide, vinblastine and estramustine. Cell death was monitored morphologically by fluorescent microscopy, and by flow cytometry (Annexin-V assay). Apoptotic morphology was rather low and ranged from 0.1% to 12.1%, 3.0% to 6.0% and 0.1% to 8.5% for etoposide, estramustine and vinblastine, respectively. Annexin-V binding and flow cytometry indicated apoptotic propensities of 0% to 4%, 0% to 3% and 0% to 5%, respectively. The percentage of cells responding to drug-induced apoptosis was, on average, higher in the tumor cell lines than in the normal cell lines, but showed no correlation with p53 status. The percentage of cells showing necrosis, assessed by Annexin binding and Propidium Iodide permeability in aqueous medium, tended to be much higher, and was found to be at the level of 5% to 30%. Immunoblotting demonstrated that bax and bcl-2 proteins were expressed at a basal level in all cell lines, but did not increase after exposure to TD(50) doses of the three drugs. The ratio of bax and bcl-2, measured by laser scanning densitometry, was not altered by the drug-induced DNA damage. The results suggest that apoptosis is not a major mechanism of drug-induced cell death in prostate cell lines and appears to be independent of p53 status and bax/bcl-2 expression.     

Apoptosis in astrocytic neoplasms

Summary Apoptosis is a form of programmed cell death characterized by specific morphologic and biochemical properties. Tumorgenesis is the consequence not only of cell proliferation but also the loss of the ability to undergo apoptosis [2]. Bcl-2 is a protooncogene which has the ability to block apoptosis in many cell types. Astrocytic neoplasms are very aggressive tumors which many times fail to respond to surgery, radiation or chemotherapy. They frequently overexpress wild-type p53 which is associated with the expression of bcl-2, and thus they may have evolved a mechanism to subvert apoptosis and allow continued growth. We examined the apoptotic index in fifty-nine astrocytic tumors of various histological grades (Oncor ApopTag PlusIn Situ Detection Kit) and compared this with the level of bcl-2 expression. Low grade astrocytomas (0.21 ±0.05; range 0.0–0.9) and anaplastic astrocytomas (0.27 ±0.13; range 0.0–2.6) had significantly less apoptosis than glioblastomas (0.70 ± 0.13; range 0.0–2.1; Kruskal-Wallis test, P 0.01). In contrast, bcl-2 expression was similar in all grades of astrocytic tumors and did not correlate with the apoptotic index. Cells of low grade and anaplastic astrocytomas are less likely to undergo apoptosis; however, this does not seem to be a direct consequence of the regulation of bcl-2 expression. The difference in growth potential despite differences in apoptotic index is likely to be attributed to differences in mitotic not apoptotic activity.     

p53 immunoreactivity correlates with Ki-67 and bcl-2 expression in renal cell carcinoma

This study assessed the relation of proliferation, inhibition of apoptosis, and the p53 tumor suppressor protein expression in clear renal cell carcinoma (RCC). Archival pathological specimens from 43 patients treated for RCC were obtained. Median follow-up for the patients was 52 months (range 2.5 months to 178 months). Immunostaining of paraffin tissue sections was carried out for four different markers: a) Ki-67, a marker for cellular proliferation; b) p53/DO7, c) p53/pAb240, antibodies for the p53 protein; and d) bcl-2, a marker for inhibition of apoptosis (programmed cell death). One thousand cells were counted per slide at 400x magnification. Staining of >/=10% of cells was considered positive and <10% negative. Fisher exact contingency tables were used for correlation between markers, tumor grade and stage. A significant correlation was found between Ki-67 and p53 immunoreactivity samples, P=0.0001. Interestingly, a significant association was found if Ki-67 and bcl-2 scores were combined and correlated with p53, P=0.009. Results showed no correlation between any of the immunohistochemical markers and grade or stage. In addition, Kaplan-Meier survival curves demonstrated no significant difference between patients' tumors that was scored immunoreactive negative vs. positive for Ki-67, p53, or bcl-2. This study indicates that p53 expression correlates with proliferation, and inhibition of programmed cell death in RCC.     

Prognostic significance of Ki-67 expression in advanced prostate cancers in relation to disease progression after androgen ablation

OBJECTIVE: This study was performed to examine the expressions of Ki-67 antigen, bcl-2 and p53 oncoprotein and to assess their capacity to predict the short-term response to the initial endocrine treatment and disease progression in prostate cancer. METHODS: Formalin-fixed and paraffin-embedded tumor tissues from a total of 73 patients with untreated prostate cancers were collected by transrectal ultrasound-guided biopsy. All patients with stage C or D prostate cancers had received continuous endocrine treatment. Ki-67 antigen, p53 and bcl-2 oncoprotein were detected by immunohistochemical methods. RESULTS: Short-term response to initial endocrine therapy judged at 3 months showed a significant correlation with Ki-67 labeling index (LI) and bcl-2 expression. Multivariate analysis showed that only a high Ki-67 LI was an independent potential predictor of prostate-specific antigen failure or the appearance of new metastasis. CONCLUSIONS: The findings suggested that the Ki-67 LI was the most useful parameter to predict disease progression after the initial endocrine treatment. Additional studies must be performed to evaluate the prognostic significance of both cell proliferation and apoptosis in detail.     

p53, bcl-2, and Bax Expression in Renal Cell Carcinoma

Objectives. Renal cell carcinomas often show a high degree of resistance to chemotherapy and radiation despite expressing normal function of the protein p53. The loss of control of apoptosis may also contribute to progression and resistance to treatment modalities and can be attributed to an interaction between p53 and the apoptotic regulators bcl-2 and Bax. To determine whether the expression of p53, bcl-2, or Bax could be correlated with outcome, we analyzed the expression pattern of these proteins in renal cell tumor samples.Methods. We examined 28 patients with clear cell renal cell carcinomas along with 7 patients with papillary renal cell carcinomas and 4 with renal oncocytomas. All renal cell carcinomas were clinically localized Stage pT2 with tumor size ranging from 4.0 to 10.3 cm (mean 6.23). Immunohistochemistry was performed on all samples and correlated with markers of outcome, including tumor grade, metastasis, recurrence, and overall survival rate.Results. In all clear cell tumors, the detection level of p53 expression was below the sensitivity of the assay, consistent with the reported infrequent incidence of p53 mutations in renal cell cancers. bcl-2 expression showed a significant correlation (P = 0.018) with higher tumor grade but could not be significantly correlated with other parameters examined including tumor recurrence, metastasis, or survival rate. The expression of Bax could similarly be correlated with higher tumor grade but with none of the other parameters.Conclusions. At the present time, the combination of both tumor grade and stage represents the best prognostic markers available. Adjunctive use of bcl-2 and Bax staining currently plays a minimal role in helping to further stratify patients at high risk for disease progression or recurrence.     

腺病毒载体介导的早幼粒细胞白血病基因生长抑制因子诱导胃癌细胞凋亡的机制研究

目的 探讨腺病毒载体介导的早幼粒细胞白血病基因（PML）生长抑制因子诱导胃癌细胞凋亡作用的机制。方法 将人PML全长cDNA插入穿梭质粒pSGCMV，再与腺病毒骨架质粒pPE3共转染293细胞后获得重组病毒。用重组病毒感染胃癌细胞系SGC-7901，采用噻唑蓝比色法、流式细胞术以及免疫细胞化学法对p53和bcl-2在肿瘤细胞内的表达以及细胞凋亡的定性与定量指标进行检测。结果 经腺病毒介导的PML处理的SGC-7901细胞生长受到明显抑制，凋亡细胞发生率升高，且与MOI值呈正相关，MOI值由5增加到20，细胞的生长抑制率从22．4％增加到38．5％，而细胞凋亡率从37．2％增加到49．8％。经腺病毒介导的PML处理的SGC-7901细胞内p53蛋白表达较对照组明显增加，bel-2蛋白的表达则无明显变化。结论 腺病毒介导的PML对胃癌细胞的杀伤主要是通过诱导细胞凋亡，p53蛋白高表达为其诱发胃癌细胞凋亡的机制之一。     

H_2O_2诱导肝细胞凋亡时p53、bcl-2mRNA的表达及其意义

目的　探讨H2 O2 诱导人类正常肝细胞系 (L0 2细胞 )凋亡时p5 3、bcl 2mRNA表达的意义及丹参有效成分Rxa对其表达的影响。方法　以正常L0 2细胞为对照 (L组 ) ,以 10 μmol/LH2 O2 诱导L0 2细胞凋亡为细胞模型 (LH组 ) ,观察Rxa处理 (LaH组 ,Rxa 2mmol/L)对 p5 3、bcl 2mRNA表达 (原位杂交结合图像分析处理 )的影响。结果　LH组 2～ 6hp5 3mRNA表达随凋亡细胞指数增高而增强 ,6～ 8h表达下降 ;bcl 2mRNA表达弱。相比较LaH组各时限检测点p5 3mRNA表达均低于LH组 ,bcl 2mRNA表达较强 (P <0 .0 1)。结论　Rxa可能通过 p5 3的细胞周期调控、DNA损伤修复作用和bcl 2的抗凋亡作用减轻L0 2细胞过氧化损伤。     

Apoptotic and proliferative indexes in esophageal cancer: Predictors of response to neoadjuvant therapy apoptosis and proliferation in esophageal cancer

Altered expression of the genes that control apoptosis and proliferation may influence the response of cancer cells to cytotoxic agents. The primary aim of this study was to determine the role of the novel an-tiapoptotic and cell cycle gene, survivin, in apoptotsis and proliferation in esophageal cancer and to evaluate whether the survivin, p53, and bcl-2 status were able to predict a patient’s response to neoadjuvant therapy. A total of 104 patients with esophageal tumors were studied. Tumor tissue was immunostained for survivin, p53, and bcl-2 proteins. Proliferative and apoptotic activity was measured using ki-67 immu-nohistochemical analysis and the TUNEL method, respectively. Forty-eight patients whose pretreat-ment biopsies were analyzed received neoadjuvant chemoradiation therapy or chemotherapy followed by surgery. Outcome was graded as a complete response, a partial response, or no response according to the results of histologic examination and CT imaging. Expression of survivin was found to correlate significantly with the proliferative index but not the apoptotic index. Patients who received neoadjuvant treatment were more likely to achieve a complete response if their tumors had high proliferative activity, and p53 positive tumors were more likely to contain residual tumor after treatment. In conclusion, survivin expression appears to foster proliferative activity in esophageal cancer, and tumors with a high proliferative index or a functioning p53 gene are more responsive to neoadjuvant chemoradiation therapy. Presented at the Forty-Third Annual Meeting of The Society for Surgery of the Alimentary Tract, San Francisco, California, May 19–22, 2002 (oral presentation). Supported by grants from the Royal College of Surgeons of England and Yorkshire Cancer Research.     

Angiogenesis, p53, bcl-2 and Ki-67 in the progression of prostate cancer after radical prostatectomy.

Within the past 5 years, research has increasingly addressed molecular alterations in prostate cancer (CaP). Mutations of tumor suppressor gene p53 have been found in a variety of cancers, including urologic neoplasms. Several studies have been conducted on CaP specimens, citing frequencies of p53 alterations in localized cancers ranging from 4 to 60% and with more advanced hormone refractory disease, as high as 94%. The majority of studies have revealed a low percentage of p53 abnormalities in early-stage (clinically organ-confined) CaP. The overwhelming bulk of evidence suggests that the frequency of p53 abnormalities does increase with disease progression and is highest in tissues from patients with hormone-refractory prostate cancer. More recently, our group and others have found that focal p53 expression in the primary tumor by immunohistochemistry is predictive of cancer recurrence after radical prostatectomy. bcl-2 is an oncogene critically involved in the apoptosis, or programmed cell death. Overexpression of bcl-2 protein by immunohistochemistry has been commonly detected in advanced hormone refractory CaP. Our group recently has also shown that bcl-2 protein expression in primary CaP is a predictor of cancer recurrence after radical prostatectomy. Furthermore, the combination of p53 and bcl-2 protein expression were both independent predictors of recurrence after surgery. Most recently, we have shown that even though p53 and bcl-2 are predictive biomarkers when sampling the radical prostatectomy specimen, they are not useful to predict postoperative recurrence when sampling the pretreatment needle biopsy. Ki-67 is an antigen of cellular proliferation. Immunohistochemical staining for Ki-67 in archival material can be performed using the MIB-1 antibody. Unlike our results with p53 and bcl-2, Ki-67 protein expression by immunohistochemistry using MIB-1 was not an independent prognostic marker for cancer recurrence after radical prostatectomy although it may have clinical utility in subsets of patients. Assessment of MIB-1 staining in CaP needle biopsy samples is underway. Tumor neovascularity, or angiogenesis, is necessary for cancers to grow and metastasize. Angiogenesis in CaP as a prognostic marker has received recent attention. Most studies have used factor VIII immunohistochemical staining and increased angiogenesis has been suggested as a staging and prognostic marker. Our group has recently conducted a large study of radical prostatectomy patients and used CD34 antigen immunohistochemistry to assess neovascularity. We did not find that this biomarker assessment was an independent prognostic marker of cancer recurrence after radical prostatectomy. Further work is being conducted in needle biopsy samples. More research is needed to assess new biomarkers and, most importantly, to standardize the methodology for sampling and assaying biomarkers in heterogeneous and multifocal prostate cancer.     

Tumor angiogenesis, apoptosis, and p53 oncogene in stage I lung adenocarcinoma

The purpose of this study was to clarify which factors are important as predictors not only of patient survival but also of hematogenic metastasis in 15 patients with stage I lung adenocarcinoma who underwent curative operation. The relationship between tumor angiogenesis, apoptosis, and p53 oncogene was also studied. A total of 15 patients were divided into two groups: surviving group (n=7) and nonsurviving (metastasis) group (n=8). We studied the medical charts, operative records, pathologic reports, and tumor specimens taken at surgical resection. We measured the apoptotic index using the ApopTag kit and the intratumoral microvessel count using an anti-CD34 monoclonal antibody. In addition, immunohistochemical staining for the expression of p53 was conducted simultaneously. The clinicopathological characteristics, including age, sex, tumor size (pT), and histological differentiation, were not significantly different between the surviving and the nonsurviving group. The microvessel count was significantly higher in nonsurviving group than in the surviving group. The apoptotic index and the expression of p53 was not significantly different between the two groups. An inverse correlation between the apoptotic index and microvessel count, and a positive correlation between the expression of p53 and microvessel count, were observed. Angiogenesis may be an important prognostic factor in patients with stage I lung adenocarcinoma.