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Reduced expression of BAX is associated with poor prognosis in patients with epithelial ovarian cancer: a multifactorial analysis of TP53, p21, BAX and BCL-2
Authors
Anttila MA
Baekelandt M
+59 more
Baekelandt M
Baekelandt M
Berns EM
Bonetti A
Buttitta F
Casey G
Diebold J
Dive C
Dong Y
E M J J Berns
Eastman A
Eastman A
el-Deiry WS
el-Deiry WS
Ferrandina G
G Stoter
Gasparini G
Hartmann LC
Henriksen R
Herod JJ
Hockenbery D
J A Foekens
J G M Klijn
J H Fieret
Kaplan E
Kassim SK
Kohler MF
Kottmeier HL
Koukourakis MI
M E L van der Burg
M P Look
M Schuyer
Mano Y
Marks JR
Marone M
Marx D
Miyashita T
Miyashita T
Miyashita T
Miyashita T
Neijt JP
Niwa K
Oltvai ZN
Oltvai ZN
Perego P
Pietenpol JA
Righetti SC
Rohlke P
S C Henzen-Logmans
Schuyer M
Shelling AN
Skilling JS
Strobel T
Strobel T
Strobel T
Tai YT
van der Burg ME
van der Zee AG
Wen WH
Publication date
2 November 2001
Publisher
Nature Publishing Group
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Abstract
Traditional clinicopathological features do not predict which patients will develop chemotherapy resistance. The TP53 gene is frequently altered in ovarian cancer but its prognostic implications are controversial. Little is known on the impact of TP53-downstream genes on prognosis. Using molecular and immunohistochemical analyses we examined TP53 and its downstream genes p21 BAX and BCL-2 in ovarian tumour tissues and have evaluated the results in relation to clinico-pathological parameters, clinical outcome and response to platinum-based chemotherapy. Associations of tested factors and patient and tumour characteristics were studied by Spearman rank correlation and Pearsons χ2 test. The Cox proportional hazard model was used for univariate and multivariate analysis. The associations of tested factors with response was tested using logistic regression analysis. TP53 mutation, p21 and BCL-2 expression were not associated with increased rates of progression and death. Expression of TP53 was associated with a shorter overall survival only (relative hazard rate [RHR] 2.01 P = 0.03). Interestingly, when combining TP53 mutation and expression data, this resulted in an increased association with overall survival (P = 0.008). BAX expression was found to be associated with both progression-free (RHR 0.44 P = 0.05) and overall survival (RHR 0.42 P = 0.03). Those patients who simultaneously expressed BAX and BCL-2 had a longer progression-free and overall survival compared to patients whose tumours did not express BCL-2 (P = 0.05 and 0.015 respectively). No relations were observed between tested factors and response to platinum-based chemotherapy. We conclude that BAX expression may represent a prognostic indicator for patients with ovarian cancer and that the combined evaluation of BAX and BCL-2 may provide additional prognostic significance. http://www.bjcancer.com © 2001 Cancer Research Campaig
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