Hepatocellular carcinoma and markers of apoptosis (bcl-2, bax, bcl-x): Prognostic significance
Hepatocellular carcinoma and markers of apoptosis (bcl-2, bax, bcl-x): Prognostic significance
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DOI：
10.1097/00022744-200209000-00004
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发表时间：
2002-09-01
影响因子：
1.6
通讯作者：
Cohen, C
中科院分区：
文献类型：
--
作者：
Garcia, EJ;Lawson, D;Cohen, C
肿瘤表达细胞凋亡促进因子（bax）和细胞凋亡抑制剂（bcl-2, bcl-x）的患者可能会增加生存期。本研究的目的是确定肝细胞癌（HCC）中凋亡标志物的表达频率及其与预后的关系。对70例HCC进行bcl-2、bax和bcl-x免疫染色。肿瘤细胞染色强度分级为0 ~ 3+。随访数据包括平均生存率（57例）和死亡率（58例）。这些值和临床参数与预后有关。bcl-2、bax和bcl-x的染色频率分别为20%、66%和60%。bax免疫染色强度与总生存期和死亡率相关：57例患者中，0 ~ 1+强度的37%中位生存期为6.6个月，2 ~ 3+强度的63%中位生存期为31.9个月（P = 0.05）；0 ~ 1+强度的19例患者死亡86%，2 ~ 3+强度的36例患者死亡50% （P < 0.05）。bcl-x染色强度倾向于与生存相关：在57例0至1+患者中，42%的患者中位生存期为32.7个月，而2至3+患者中位生存期为5.8个月（P = 0.06）。通过多变量分析，这种关系在bax （P = 0.011）和bcl-x （P = 0.048）中成立。bcl-2表达、分期、性别与预后无相关性。在单因素和多因素模型中，与bax不表达或低表达的HCC患者相比，表达bax的HCC患者的生存率更高。与HCC中bcl-x含量较高的患者相比，无bcl-x或低bcl-x的患者倾向于改善生存。Bcl-2表达与预后无相关性。
Patients with tumors expressing promoters of apoptosis (bax) versus inhibitors of apoptosis (bcl-2, bcl-x) may have increased survival. The purpose of this study was to determine the frequency of expression of apoptotic markers in hepatocellular carcinoma (HCC) and their relationship with prognosis. Seventy HCC were immunostained for bcl-2, bax, and bcl-x. Staining intensity in tumor cells was graded 0 to 3+. Follow-up data were available for mean survival (57 cases) and death rates (58 cases). These values and clinical parameters were related to prognosis. Staining frequency for bcl-2, bax, and bcl-x was 20%, 66%, and 60%, respectively. Immunostaining intensity of bax correlated with overall survival and death rates: of 57 patients, the 37% with 0 to 1+ intensity had a median survival of 6.6 months, the 63% with 2 to 3+ intensity had a median survival of 31.9 months (P = 0.05); 86% of 19 patients with 0 to 1+ intensity died, and 50% of 36 patients with 2 to 3+ intensity died (P < 0.05). Intensity of bcl-x staining tended to correlate with survival: of the 57 patients with 0 to 1+, 42% had a median survival of 32.7 months compared with 5.8 months in the 58% with 2 to 3+ intensity (P = 0.06). By multivariate analysis, this relationship held for bax (P = 0.011) and bcl-x (P = 0.048). There was no correlation between bcl-2 expression, stage, or gender and prognosis. Patients with baxexpressing HCC experience improved survival compared with those with no or low bax expression, in uni- and multivariate models. Patients with no or low bcl-x tended toward improved survival compared with patients with more bcl-x in their HCC. bcl-2 expression did not correlate with prognosis.