Apoptosis and bcl-2 expression as predictors of survival in radiation-treated non-small-cell lung cancer

被引:36
作者
Hwang, JH
Lim, SC
Kim, YC
Park, KO
Ahn, SJ
Chung, WK
机构
[1] Chonnam Natl Univ, Sch Med, Dept Internal Med, Kwangju 501757, South Korea
[2] Chonnam Natl Univ, Sch Med, Dept Radiat Oncol, Kwangju, South Korea
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2001年 / 50卷 / 01期
关键词
apoptosis; bcl-2; p53; c-myc; radiation therapy; NSCLC;
D O I
10.1016/S0360-3016(00)01558-3
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objectives: We assessed the role of apoptosis and the expression of bcl-2, p53, and c-myc oncoproteins in pretreatment histologic specimens as a predictor of response to radiation therapy and survival in non-small-cell lung cancer (NSCLC) patients. Methods: Pretreatment biopsy specimens of 68 patients with NSCLC (62 squamous cell carcinoma, 6 adenocarcinoma) were stained with hematoxylin and eosin, From 5 high-powered fields, the apoptotic index (AI) was calculated as the ratio of apoptotic tumor cells to the total number of tumor cells. Bcl-2, p53, and c-myc oncoprotein expression was detected by immunohistochemical staining. Results: Twenty-nine cases showed partial or complete remission, whereas 39 showed no response. AI ranged from 0.2 to 12.0% (mean +/- SD; 4.3 +/- 2.6%, median 4.0%), There was no difference in AI between responders (4.0 +/- 2.3) and nonresponders (4.5 +/- 2.8, p > 0.05). However, in the responders, AI was correlated with the degree of change in tumor volume (r = 0.41, p < 0.05). In an analysis of 53 subjects who survived more than I month after the completion of radiation therapy, the patients with a higher AI (n = 27, MST = 22.8 m) survived longer than those with a fewer AI (n = 26, MST = 9.2, log-rank, p = 0.03). Patients expressing bcl-2 had poorer survival (n = 22, MST = 6.0 m) than patients without bcl-2 (n = 31, 22.8 m,p < 0.003). According to multivariate analysis, three variables, bcl-2 expression, AI, and response to radiation, were independent prognostic factors for survival. Conclusion: A low level of spontaneous apoptosis and expression of apoptosis blocking bcl-2 protein in pretreatment histology predict a poor prognosis for radiation-treated NSCLC patients. (C) 2001 Elsevier Science Inc.
引用
收藏
页码:13 / 18
页数:6
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