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Prognostic value of bcl-2 expression among women with breast cancer in Libya

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Tumor Biology

Abstract

We studied the association of the immunohistochemical bcl-2 expression in Libyan breast cancer with clinicopathological variables and patient outcome. Histological samples from 170 previously untreated primary Libyan breast carcinoma patients were examined. In immunohistochemistry, the NCL-l-bcl-2-486 monoclonal antibody was used. Positive expression of bcl-2 was found in 106 patients (62.4 %). The bcl-2 expression was significantly associated with estrogen receptor (p < 0.0001) and progesterone receptor positive tumors (p = 0.002), small tumor size (p < 0.0001), low tumor grade (p < 0.0001), negative axillary lymph nodes (p < 0.0001), early stages (p = 0.001), and low risk of metastasis (p < 0.0001). Positive expression was also associated with older patients (>50 years; p = 0.04). Histological subtypes and family history of breast cancer did not have significant relationship with bcl-2. Patients with positive expression of bcl-2 had lower recurrence rate than bcl-2-negative patients and better survival after median follow-up of 47 months. Patients with high bcl-2 staining were associated with the best survival. The role of bcl-2 as an independent predictor of disease-specific survival was assessed in a multivariate survival (Cox) analysis, including age, hormonal status, recurrence, histological grade, and clinical stage variables. Bcl-2 (p < 0.0001) and clinical stage (p = 0.016) were independent predicators of disease-specific survival. For analysis of disease-free survival, the same variables were entered to the model and only bcl-2 proved to be an independent predictor (p = 0.002). Patients with positive expression of bcl-2 were associated with low grade of malignancy, with lower recurrence rate, with lower rate of death, and with longer survival time. Bcl-2 is an independent predictor of breast cancer outcome, and it provides useful prognostic information in Libyan breast cancer. Thus, it could be used with classical clinicopathological factors to improve patient selection for therapy.

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Acknowledgments

The authors acknowledge the Libyan Health Ministry for financing the visit of Dr. Ermiah to the Departments of Pathology and Oncology, University of Turku, and Turku University Hospital, Finland. We also wish to thank the National Oncology Institute, Sabratha, Libya for support in collecting the data and providing the research facilities.

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Authors and Affiliations

  1. Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland

    Eramah Ermiah & Seppo Pyrhönen

  2. Department of Oncology, National Cancer Institute, Sabratha, Libya

    Eramah Ermiah

  3. Center of Excellence in Genomic Medicine Research, King Abdul-Aziz University, Jeddah, Saudi Arabia

    Abdelbaset Buhmeida

  4. Department of Pathology, Salah Azaiz Cancer Institute, Tunis, Tunisia

    Ben Romdhane Khaled

  5. Department of Pathology, Misurata Cancer Institute, Misurata, Libya

    Fathi Abdalla

  6. Department of Biochemistry, King Abdul-Aziz University, Jeddah, Saudi Arabia

    Nada Salem

  7. Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland

    Yrjö Collan

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  1. Eramah Ermiah
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  2. Abdelbaset Buhmeida
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  3. Ben Romdhane Khaled
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  4. Fathi Abdalla
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Correspondence to Eramah Ermiah.

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Ermiah, E., Buhmeida, A., Khaled, B.R. et al. Prognostic value of bcl-2 expression among women with breast cancer in Libya. Tumor Biol. 34, 1569–1578 (2013). https://doi.org/10.1007/s13277-013-0687-1

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  • DOI: https://doi.org/10.1007/s13277-013-0687-1

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