International Journal of Colorectal Disease

, Volume 24, Issue 6, pp 655–663

Prognostic implications of BAX protein expression and microsatellite instability in all non-metastatic stages of primary colon cancer treated by surgery alone

  • Oliver Nehls
  • Holger G. Hass
  • Thomas Okech
  • Silke Zenner
  • Chih-Jen Hsieh
  • Mario Sarbia
  • Franz Borchard
  • Hans-Helmut Gruenagel
  • Vera Gaco
  • Rainer Porschen
  • Michael Gregor
  • Bodo Klump
Original Article

DOI: 10.1007/s00384-009-0635-0

Cite this article as:
Nehls, O., Hass, H.G., Okech, T. et al. Int J Colorectal Dis (2009) 24: 655. doi:10.1007/s00384-009-0635-0

Abstract

Purpose

This study examined whether the apoptosis-related protein, BAX, or the microsatellite-instability phenotype provide prognostic information in patients with resected colon cancer.

Methods

A total of 371 stage I–III patients that previously underwent radical surgery were included (mean follow-up 51.8 months). BAX expression was examined by immunohistochemical staining; high-frequency microsatellite instability (MSI+) was determined by assessing the specific marker, BAT26, using single-strand conformation polymorphism (SSCP)-based analysis.

Results

High BAX expression was found in 66.4% of patients. MSI+ tumors were observed in 14.8% of 344 patients. Univariate analysis showed that unlike MSI, low BAX expression was significantly correlated with poor disease-specific overall survival (OS) in stages I–III (p = 0.04). Multivariate subgroup analyses revealed that unlike MSI, low BAX was an independent predictor for OS in stage II (p = 0.009); however, in stages I or III, BAX or MSI were not independent predictors of OS.

Conclusions

In stage II colon cancer treated with surgery alone, BAX protein expression may be a predictor for prognosis.

Keywords

BAT26 BAX Colon carcinoma Microsatellite instability BAX/MSI phenotype 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Oliver Nehls
    • 1
    • 2
    • 7
  • Holger G. Hass
    • 2
  • Thomas Okech
    • 1
  • Silke Zenner
    • 1
  • Chih-Jen Hsieh
    • 1
  • Mario Sarbia
    • 3
  • Franz Borchard
    • 4
  • Hans-Helmut Gruenagel
    • 5
  • Vera Gaco
    • 1
  • Rainer Porschen
    • 6
  • Michael Gregor
    • 1
  • Bodo Klump
    • 1
  1. 1.Department of Internal Medicine IUniversity HospitalTübingenGermany
  2. 2.Department of Internal Medicine IIUniversity HospitalTübingenGermany
  3. 3.Institute of PathologyMunichGermany
  4. 4.Department of PathologyKlinikum AschaffenburgAschaffenburgGermany
  5. 5.Department of SurgeryEvangelic HospitalDüsseldorfGermany
  6. 6.Clinic of Internal MedicineCentral Hospital Bremen OstBremenGermany
  7. 7.Medizinische Universitätsklinik und PoliklinikTübingenGermany

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