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Immunohistochemical expression of bcl-2 in UICC stage I and III colorectal carcinoma patients: correlation with c-erbB-2, p53, ki-67, CD44, laminin and collagen IV in evaluating prognostic significance.

BACKGROUND: The objective of this study was to evaluate the expression of bcl-2 in UICC stage I and stage III (Dukes's stage B and C) colorectal adenocarcinoma and to examine its association with clinicopathological features, c-erbB-2, p53, ki-67, CD44, laminin and collagen IV and long term outcome.

METHODS: Paraffin embedded specimens from 61 patients with UICC stage I (Dukes's stage B) and 39 patients with UICC stage III (Dukes's stage C) colorectal adenocarcinoma who were treated with surgery were assessed. We determined by immunohistochemistry the expression of bcl-2, c-erB-2, p53, ki-67, CD44, laminin and collagen IV with 5 year follow up.

RESULTS: Cytoplasmic staining of the bcl-2 gene product was seen in the tumour cells of 27 cases (27%). Expression of bcl-2 protein was unrelated to patient sex, age, tumour site or tumour grade, but was related to tumour stage (p = 0.012). No significant association was demonstrated between bcl-2 and c-erbB-2, p53 or CD44. However, there was very strong evidence of correlation between bcl-2 staining and ki-67, laminin and collagen IV. There was a trend towards increased survival in patients whose tumours expressed bcl-2 protein. When a correlation between bcl-2 and the other markers had been made the positive expression of bcl-2 was beneficial.

CONCLUSIONS: The results from this study would suggest that expression of bcl-2 appear to be useful in selecting a group of colorectal cancer patients with a better prognosis.

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