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Prognostic significance of p53, bcl-2 and Ki67
in non-small-cell lung carcinoma
Maounis N.1, Çorti M.1, Trakas N.1, Blana Aik.,
Aggelidou M.1, Apostolikas N.2, Legaki S.1
1Sismanoglion General Hospital,
2Saint Savas Hospital, Athens, Greece
The prognosis of patients with operable non-small cell lung cancer (NSCLC) remains poor despite thorough pre-operative staging. An improved preselection of patients likely to benefit from surgery and post surgery chemotherapy and/or radiotherapy is needed. This study was undertaken in order to evaluate the prognostic significance of Ki-67 labeling index and p53 and bcl-2 protein expression. Immunohistochemical staining for p53, bcl-2 and Ki-67 was performed on paraffin sections from 84 NSCLC, from patients who had complete and potentially curative surgery. Our results were related to various clinical and pathological parameters (patient's age, sex, disease stage and tumor type, size and differentiation). The median follow-up time of surviving patients was 23.86 months. In our study, the only statistically significant parameter for survival was stage (p=0.000), whereas Ki-67 and p53 revealed a borderline significance (p=0.09 and p=0.08). When a multivariate analysis was performed, stage was an independent prognostic factor with 10% relative risk after Cox proportional - hazard step - wise elimination. Furthermore, in univariate analysis, statistically significant correlation was demonstrated with the 51-60 age group, poor differentiation and Ki-67 positivity (p<0.0109, p<0.0547). Finally, a statistically significant correlation was revealed between the adenocarcinoma group and Ki-67 and p53 positivity (p<0.0111 and p<0.0433 respectively). In conclusion, in our study bcl-2 expression has no prognostic value for patients with resected NSCLC, whereas Ki-67 and p53 overexpression may help to predict the outcome for patients with lung adenocarcinoma.
Key words: Ki67, p53, bcl-2, non-small-cell lung cancer, immunohistochemical staining.
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