BCL-2, p53 and HLA-DR antigen expression in surgically treated parotid cancer patients

• Published in: European archives of oto-rhino-laryngology 2009-03, Vol.266 (3), p.417-424
• Main Authors: Genetzakis, Michael, Gomatos, Ilias P., Georgiou, Anastasia N., Giotakis, John, Manolopoulos, Leonidas, Papadimitriou, Κonstantina, Chra, Helen, Leandros, Emmanuel, Tsigris, Christos, Ferekidis, Eleutherios A.
• Format: Article
• Language: English
• Subjects: Adjuvants; Adult; Aged; Aged, 80 and over; Bcl-2 protein; Cancer; Cervix; Female; Head and Neck; Head and Neck Surgery; Histocompatibility antigen HLA; HLA-DR Antigens - metabolism; Hospitals; Humans; Immunohistochemistry; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Neoplasm Staging; Neurosurgery; Nodes; Otorhinolaryngology; p53 protein; Parotid Neoplasms - metabolism; Parotid Neoplasms - mortality; Parotid Neoplasms - surgery; Preoperative Care; Prognosis; Proto-Oncogene Proteins c-bcl-2 - metabolism; Radiotherapy; Retrospective Studies; Survival; Survival Rate; Tumor Suppressor Protein p53 - metabolism; Tumors
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-008-0754-1

Our objective was to investigate the prognostic significance of bcl-2 protein, p53 protein and HLA-DR antigen expression in a group of surgically treated parotid cancer patients. We studied bcl-2, p53 and HLA-DR immunohistochemical expression in paraffin-embedded surgically removed tissue specimens derived from 26 patients with parotid cancer and 9 patients with Warthin parotid tumors operated between 2000 and 2006 at the Hippokration Hospital of Athens. The staining results were correlated with the patients’ clinicopathological characteristics and clinical outcome. Bcl-2 expression was associated with a significantly decreased survival in patients with advanced tumor stage ( P = 0.04), high grade lesions ( P = 0.02), or cervical node involvement ( P = 0.03). Radiotherapy was associated with a significantly improved recurrence-free survival among patients with negative tumor staining for either bcl-2, or both HLA-DR and bcl-2 [HLA-DR(−)/Bcl-2(−)] ( P = 0.04 for both comparisons). Classical clinicopathologic factors failed to show prognostic value both in the univariate and the multivariate analyses performed. Our results suggest that bcl-2 can be used to identify locally advanced or histologically aggressive tumors with a lower survival probability following the application of standard treatment modalities. Furthermore, bcl-2(+) patients should be considered for more aggressive adjuvant treatment protocols, since conventional radiotherapy often fails to decrease relapse rates in this setting of patients.