Bcl-2 and p53 expression as prognostic markers in malignant epithelial ovarian tumours [EOC]

ABSTRACT

This study aimed to investigate the prognostic and predictive relevance of Bcl-2 and P53 protein expression in epithelial ovarian carcinoma [EOC] and to evaluate the results in relation to clinicopathologic parameters, clinical outcome and response to chemotherapy. Tumor biopsy specimens from 56 consecutive and homogeneously treated patients with FIGO stages II and III epithelial ovarian cancer [EOC] were examined immunohistochemically for expression of Bcl-2 and P53 proteins. All patients received chemotherapy [CAP] after the primary surgery. A number of clinicopathologic factors [age, duration of symptoms before diagnosis, FIGO stage, histologic type, degree of differentiation, laterality, capsular invasion, peritoneal deposits, tumour size, ascites and residual disease] were studied in relation to the tissue markers Bcl-2 and P53. Both uni-and multivariate analysis of prognostic factors were performed and the relations to classical clinicopathologic parameters and response to chemotherapy were examined. The results revealed that Bcl-2 and P53 positive expression were found in 41.1% and 14.3% of the cases, respectively. Bcl-2 expression was related to age above 50 years, lower FIGO stage, absence of ascites, absence of residual disease, resistance to chemotherapy and negative P53 expression. For P53 expression, a positive relation was found with age above 50 years, duration of symptoms less than 6 months, lower FIGO stage, absence of ascites and partial response to chemotherapy. All cases with P53 positive expression were FIG0 stage II and with moderate or poor histologic differentiation. The presence of Bcl-2 expression and absence of P53 expression were associated with improved disease free survival but not overall survival. In multivariate analysis, age, FIGO stage and degree of differentiation retained independent prognostic significance with overall survival. When disease free survival was used as an end point, only FIGO stage and association groups of Bcl-2 and P53 expression were of independent significance. It was concluded that Bcl-2, P53 or an association of the two markers expression data may represent prognostic predictors in epithelial ovarian cancer [EOC]