Apoptosis regulator proteins p53 and bcl-2 are independent prognostic biomarkers in surgically treated clinically localized prostate cancer patients

Background : Overexpression of both the mutant p53 and bcl-2 proteins in advanced prostate cancer (PC) has been impli-cated in hormone refractory disease and poor prognosis. p53 expression has been shown to be an independent prognostic marker for progression in PC. bcl-2 overexpress ion has not been studied as a prognostic marker in a large series. Method : The relationship between immunohistochemical (IHC) staining for pB3 and bcl-2 protein expression was evaluated in prostatectomy specimens from 175 patients with clinically localized prostate cancer. Clinical follow-up ranged from 1-9 years (mean=4.6 years). Results: bcl-2 Overexpression was noted in 26.9% of pat ients with a higher 5-year failure rat e than those who did not overexpress bcl-2 (67.0% vs. 30.5%). bcl-2 expres-sion did not show any correlation to age and race ; higher expression was noted with higher stage, Gleason score, and nuclear grade. p53 expression was noted in 65.1% of patients with a 5-year failure rate of 51.1%, compared to p53 negative patients with a 5-year failure rate of 22%. when p53 and bcl-2 expression were combined, the 5-year fai lure rate was at 20.4%. Univariate Kaplan-Meier analysis showed a statistically significant differenee between p53 and bcl-2 posit ive & negacive patients (p<0.001) . Multivariate Cox Regression Analysis with backward elimination control1ing for age, race, stage, & grade showed p53 (p=.01851 and bcl-2 (p=.044) to be independent predictors of disease-free survival.

Duke Scholars

Author Judd Wendell Moul Urology