Expression of apoptosis-related proteins is an independent determinant of patient prognosis in advanced ovarian cancer.

Abstract

PURPOSE:

The present study was undertaken to investigate the prognostic and predictive relevance of the expression of apoptosis-related proteins Bax, Bcl-X(L), and Mcl-1 in advanced ovarian cancer.

PATIENTS AND METHODS:

Tumor biopsies from 185 consecutive and homogeneously treated patients with stage III ovarian cancer were examined immunohistochemically for the expression of Bax, Bcl-X(L) and Mcl-1 proteins. Their prognostic relevance was examined in a uni- and multivariate survival analysis.

RESULTS:

Sixty-six percent of cancer cases expressed Bax, 62% Bcl-X(L), and 53% Mcl-1. The expression of Bax correlated with tumor differentiation (P: =.016) and less residual disease after surgery (P <.0001). In univariate analysis, Bax expression was associated with improved (P =.0004) prognosis and Mcl-1 expression with poorer (P =.011) prognosis. None of the factors studied was of independent prognostic significance by itself, but when Bax and Bcl-2 expression data were considered together, this combined variable was of independent prognostic significance (P =.0115), together with residual disease status (P =.0016), differentiation grade (P =.0014), and the presence of ascites (P =.0122). Patients with a long median survival (104 months) could be discriminated from those with a short one (16 months) by combining the individual patients' expression data for p53, Bax, and Bcl-2 with their residual disease status (P <.00001). None of the factors studied was able to predict response to chemotherapy.

CONCLUSION:

The expression of selected apoptosis-related proteins is of independent prognostic significance and may be helpful in a molecular substaging of patients with stage III ovarian cancer.

• Authors: M Baekelandt, R Holm, J M Nesland, C G Tropé, G B Kristensen
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 18 Issue 22 Pg. 3775-81 (Nov 15 2000) ISSN: 0732-183X [Print] United States
• PMID: 11078490 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• BAX protein, human
• BCL2L1 protein, human
• Biomarkers, Tumor
• Myeloid Cell Leukemia Sequence 1 Protein
• Neoplasm Proteins
• Proto-Oncogene Proteins
• Proto-Oncogene Proteins c-bcl-2
• bcl-2-Associated X Protein
• bcl-X Protein

Topics

• Adult
• Aged
• Apoptosis (physiology)
• Biomarkers, Tumor (biosynthesis)
• Clinical Trials as Topic
• Female
• Humans
• Immunohistochemistry
• Middle Aged
• Multicenter Studies as Topic
• Myeloid Cell Leukemia Sequence 1 Protein
• Neoplasm Proteins (biosynthesis)
• Neoplasm Staging
• Ovarian Neoplasms (metabolism, mortality, pathology)
• Predictive Value of Tests
• Prognosis
• Proto-Oncogene Proteins (biosynthesis)
• Proto-Oncogene Proteins c-bcl-2 (biosynthesis)
• Survival Analysis
• bcl-2-Associated X Protein
• bcl-X Protein