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Potential Role of Apoptosis and Apoptotic Regulatory Proteins in Colorectal Neoplasia: Correlations with Clinico-Pathological Parameters and Survival

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Abstract

An imbalance between apoptotic and proliferative processes is believed to underlie colorectal neoplasia. We evaluated the expression of bcl-2, p53, mdm2 proteins, and apoptosis in colorectal neoplasms, as well as their correlation with clinico-pathological parameters, using image analysis. Biopsies from 46 colorectal cancers, 121 adenomas, and 25 controls were studied using monoclonal antibodies against p53, bcl-2, mdm2 and the terminal deoxynucleotidyl-transferase-mediated dUTP nick end labeling (TUNEL) method for apoptosis. P53 and bcl2 protein expression was higher in adenomas ≥1 cm (P < 0.03) and tubulovillous-villous adenomas (P < 0.03), and correlated with dysplasia (P < 0.03). In Cox regression analysis, Dukes’ stage was the most significant independent prognostic indicator of a worse survival (P < 0.019), whereas when stage was eliminated, bcl-2 expression was also a powerful predictor for bad prognosis (P = 0.02).

In conclusion, both bcl-2 and p53 immunohistochemical profiles may be useful adjuncts in detecting adenomas with a malignant potential, whereas bcl-2 could be used in combination with Dukes’ stage as a predictor of prognosis in colorectal cancer.

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Authors and Affiliations

  1. Department of Gastroenterology, “Agia Varvara” General Hospital, 2 Nevrokopiou str, 15669, Athens, Greece

    Maria Tzouvala

  2. 1st Department of Pathology, Medical School, The National and Kapodistrian University of Athens, Athens, Greece

    Andreas C. Lazaris, Thomas G. Papathomas, Nikos Kavantzas & Emmanouil Agapitos

  3. 2nd Department of Internal Medicine, “Hippokration” General Hospital of Athens, Medical School of Athens University, Athens, Greece

    George V. Papatheodoridis

  4. Department of Pathology, “Elpis” General Hospital, Athens, Greece

    Chariklia Kouvidou

  5. Department of Pathology, “Tzaneion” General Hospital of Piraeus, Piraeus, Greece

    Ioannis Elemenoglou

  6. 2nd Department of Gastroenterology, “Evangelismos” General Hospital of Athens, Athens, Greece

    Demetrios G. Karamanolis

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  1. Maria Tzouvala
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Correspondence to Maria Tzouvala.

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Tzouvala, M., Lazaris, A.C., Papatheodoridis, G.V. et al. Potential Role of Apoptosis and Apoptotic Regulatory Proteins in Colorectal Neoplasia: Correlations with Clinico-Pathological Parameters and Survival. Dig Dis Sci 53, 451–460 (2008). https://doi.org/10.1007/s10620-007-9857-6

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