The prognostic significance of apoptosis-associated proteins BCL-2, BAX and BCL-X in clinical nephroblastoma

• Published in: British journal of cancer 2001-11, Vol.85 (10), p.1557-1563
• Main Authors: Ghanem, M A, Van der Kwast, T H, Den Hollander, J C, Sudaryo, M K, Van den Heuvel, M M, Noordzij, M A, Nijman, R J M, Soliman, E H, van Steenbrugge, G J
• Format: Article
• Language: English
• Subjects: Antibodies; Apoptosis; bcl-2-Associated X Protein; bcl-X Protein; Bcl-xL gene; Biological and medical sciences; Biomarkers, Tumor - metabolism; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cancer therapies; Cell death; Chemotherapy; Child, Preschool; Disease Progression; Drug Resistance; Epidemiology; Female; Humans; Immunohistochemistry; Kidney - metabolism; Kidney Neoplasms - diagnosis; Kidney Neoplasms - metabolism; Kidney Neoplasms - pathology; Kidneys; Male; Medical sciences; Metastasis; Molecular Medicine; nephroblastoma; Nephrology. Urinary tract diseases; Oncology; Pediatrics; Prognosis; Proteins; Proto-Oncogene Proteins - immunology; Proto-Oncogene Proteins - metabolism; Proto-Oncogene Proteins c-bcl-2 - immunology; Proto-Oncogene Proteins c-bcl-2 - metabolism; Regular; regular-article; Treatment Outcome; Tumors; Tumors of the urinary system; Wilms Tumor - diagnosis; Wilms Tumor - metabolism; Wilms Tumor - pathology
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1054/bjoc.2001.2146

Apoptotic cell death represents an important mechanism for the precise regulation of cell numbers in normal tissues. Various apoptosis-associated regulatory proteins, such as Bcl-2, Bax and Bcl-X, may contribute to the rate of apoptosis in neoplasia. The present study was performed to evaluate the prognostic value of these molecules in a group of 61 Wilms’ tumours of chemotherapeutically pre-treated patients using an immunohistochemical approach. Generally, Bcl-2, Bax and for Bcl-X S/L were expressed in the blastemal and epithelial components of Wilms’ tumour. Immunoreactive blastema cells were found in 53%, 41% and 38% of tumours for Bcl-2, Bax and for Bcl-X S/L , respectively. An increased expression of Bcl-2 was observed in the blastemal component of increasing pathological stages. In contrast, a gradual decline of Bax expression was observed in the blastemal component of tumours with increasing pathological stages. Also blastemal Bcl-X S/L expression decreased with stage. Univariate analysis showed that blastemal Bcl-2 expression and the Bcl-2/Bax ratio were indicative for clinical progression, whereas epithelial staining was of no prognostic value. Multivariate analysis showed that blastemal Bcl-2 expression is an independent prognostic marker for clinical progression besides stage. These findings demonstrate that alterations of the Bcl-2/Bax balance may influence the clinical outcome of Wilms’ tumour patients by deregulation of programmed cell death. © 2001 Cancer Research Campaign http://www.bjcancer.com