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Bcl‐2 expression is associated with improved prognosis in patients with distal colorectal adenocarcinomas
Author(s) -
Manne Upender,
Weiss Heidi L.,
Grizzle William E.
Publication year - 2000
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/1097-0215(20000920)89:5<423::aid-ijc5>3.0.co;2-t
Subject(s) - medicine , oncology , colorectal cancer , proportional hazards model , immunohistochemistry , multivariate analysis , confounding , population , adenocarcinoma , stage (stratigraphy) , univariate analysis , biopsy , survival analysis , pathology , cancer , biology , paleontology , environmental health
Several recent studies have suggested that the anatomic location of the tumor and ethnicity of the patient should be considered in the evaluation of prognostic markers of colorectal neoplasia. The phenotypic expression of Bcl‐2 has been reported to be a useful prognostic marker in colorectal adenocarcinoma (CRC). However, its prognostic importance in CRCs based on their anatomic location and on the ethnicity of the patients has not been reported. Therefore, we evaluated Bcl‐2 expression by immunohistochemistry in CRCs collected from 107 African‐American and 149 Caucasian patients from a southern U.S. population. In univariate Kaplan‐Meier survival analyses, Bcl‐2 expression was associated with better overall survival of both African‐American (log‐rank, p = 0.040) and Caucasian (log‐rank, p = 0.032) patients with distal but not with proximal CRCs. In multivariate Cox regression analyses, when the pathologic features of tumors were not included, the expression of Bcl‐2 was associated with better survival in either ethnic patient populations with distal CRCs after adjusting for other confounding variables and p53 nac status; however, it was not significant in either race when tumor stage was included in multivariate analyses. Thus, these studies suggest that the expression of Bcl‐2 in CRCs is a valuable indicator of good prognosis in either race when CRCs are located in the distal colorectum. Also, these studies suggest that the expression of Bcl‐2 is useful in determining prognosis before pathologic‐clinical staging and it can aid in selection of treatment after evaluation of diagnostic biopsy specimens of patients with distal colorectal adenocarcinomas. Int. J. Cancer 89:423–430, 2000. © 2000 Wiley‐Liss, Inc.