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Article
Bcl-2 oncoprotein expression in breast cancer, its relation to estrogen and progesterone receptors and other prognostic factors

Authors: Kassim S. Ibrahim قاسم سعيد ابراهيم --- Banan B. Mohammed بنان برهان محمد
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2009 Volume: 35 Issue: 2 Pages: 117-123
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACT
Aims of the study: To evaluate the expression of the Bcl-2 oncoprotein in patients with primary breast cancer, to correlate it with estrogen and progesterone receptors and various prognostic parameters.
Patients and methods: Fifty two cases of primary breast cancer in which the estrogen and progesterone receptors statuses were previously tested by immuno-histochemical staining, were included in this retrospective study. The cases were collected from Al- Jamhori Teaching Hospital, Nineveh Private Hospital and Private laboratories. The expression of Bcl-2 oncoprotein was evaluated immunohistochemically; the findings were correlated with the estrogen and progesterone receptors, the age of the patients, size, type and grade of the tumor, lymph node status and vascular invasion.
Results: Bcl-2 oncoprotein was detected in 24 cases of primary breast cancer (46.2%). In this study the majority of estrogen and progesterone receptors positive cases, (87.5%) and (83.3%) respectively, showed positive Bcl-2 oncoprotein expression, (P<0.001) and (P=0.0002) respectively. A significant association was found between Bcl-2 and tumor type (P=0.017). Bcl-2 oncoprotein was directly correlated with the age of the patients (P=0.0047), and inversely with the grade of the tumor and vascular invasion (P value = 0.0092, <0.001) respectively. No significant correlation with tumor size nor with lymph node status could be found, (P=0.078) and (P=0.19) respectively.
Conclusions: Bcl-2 oncoprotein was positive in 46.2% of primary breast cancer. This study revealed a significantly direct correlation between the Bcl-2 and the estrogen and progesterone receptors. A significant association was found between Bcl-2 oncoprotein and tumor type. Bcl-2 was directly related to the age of the patients, and inversely related to the grade of the tumor and vascular invasion.
Keywords: Bcl-2 oncoprotein, breast cancer, estrogen receptor, progesterone receptor.

الخلاصةأهداف الدراسة: تهدف هذه الدراسة الى تقيّم تعبير البروتين السرطاني Bcl-2 لمرضى سرطان الثدي الابتدائي، وإيجاد علاقتها بمُستقبِلات الاستروجين والبروجستيرون والمثبتات الانذارية المختلفة.المرضى وطرق العمل: اثنان وخمسون حالة من حالات سرطان الثدي الأبتدائيِ التي فيها حالة مُستقبِلات الاستروجين ومستقبلات البروجستيرون قد أختبرت َبكيمياء النسيج المناعي سابقاً، تم اختبارها في هذه الدراسةِ ذات الأثر الرجعي، وقد جُمِعتْ الحالات من مستشفى الجمهوري التعليمي ومستشفى نينوى الخاص والمختبرات الخاصّة. قُيّم تعبير البروتين السرطاني Bcl-2 بكيمياء النسيج المناعي وتم تحليل النَتائِج وفقآ لعُمر المرضى و حجمِ السرطان، نوعه ، درجته و حالة العُقد اللمفاوية، الغزو الوعائي ووجود مستقبلات الاستروجين والبروجستيرونِ.النتائج: وجد البروتين السرطاني Bcl-2 في ٢٤ حالة من حالات سرطان الثدي (٢,٤٦%) و ان أغلبية الحالات التي فيها مُستقبِلات الاستروجين إيجابية (٥,٨٧%) أظهرت نتيجة ايجابية للبروتين السرطاني Bcl-2 (٠٠١,٠P <) وأيضاً أغلبية الحالات التي كانت فيها مُستقبِلات البروجستيرونِ إيجابيةِ (٣,٨٣ %) كانت ايجابية لتعبير Bcl-2 (٠٠٠٢,٠P=). وقد وجدت علاقة هامة بين Bcl-2 ونوع السرطان (٠١٧,٠ P=) والبروتين السرطاني Bcl-2 كانت له علاقة مباشرة بعُمر المرضى (٠٠٤٧,٠P=) وعلاقة عكسية بدرجة الورم والغزو الوعائي (٠٠٩٢,٠ P =، ٠٠١,٠P< على التوالي). لم يتم الحصول على علاقةَ هامّةَ بين Bcl-2وحجم الورم (٠٧٨,٠ P=). أيضاً لم يظهر البروتين السرطاني Bcl-2علاقةَ هامّةَ مع حالة العُقد اللمفاويةَ (١٩,٠P=). الاستنتاجات: البروتين السرطاني Bcl-2 كَان إيجابي في ٢,٤٦% من حالات سرطان الثدي الأبتدائي. وقد أظهرت هذه الدراسة علاقة مباشرة وهامة بين Bcl-2 ومستقبلات الاستروجين والبروجستيرون كما وجدت علاقة هامة بين نوع السرطان والبروتين السرطاني .Bcl-2 البروتين السرطاني Bcl-2كانت له علاقة مباشرة بعُمر المرضى وعلاقة عكسية بدرجة الورم وغزو الأوعية.


Article
The Significance of Estimation of Anti- Apoptotic Protein in Acute Leukemia Cases

Author: Waseem Fadhil Al‐Tememi
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2009 Volume: 8 Issue: 1 Pages: 53-58
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background Apoptosis is a terminal cell fate that eliminates physiological unneeded or dangerous cells. The Bcl-2 oncoprotein encodes a mitochondrial protein that blocks apoptosis. High levels of Bcl-2 protein are found in different malignancies including acute leukemias and it is thought to be directly involved in the emergence of drug resistance by disrupting &/or delaying apoptotic program and promoting tumor survival. Objectives To analyze the significance of any variation in the level of Bcl-2 expression according to disease progress (from time of diagnosis to time of remission or resistance) in cases with acute leukemia, and whether to consider this variation as a prognostic marker. Methods: Through a prospective study, 25 samples of bone marrow aspirates were taken from different patients who attended the hematology unit of Baghdad teaching hospital in the medical city from December 2005 to July 2006, who proved to have acute leukemia in its different types or subtypes(ALL and AML) & at a variable phases of the disease course. Monoclonal antibody targeted against Bcl-2 oncoprotein via immunocytochemistry staining techniques of these aspirates was performed in order to define the level of Bcl-2 protein carrying cells & looking for any differences in this expression in relation to disease progress or treatment hoping to translate these findings in terms of prognosis. Results Despite the heterogenous expression of Bcl-2 protein carrying cells in each case(0-500 cells out of 500 cells)of AML or ALL , it was found to be in positive correlation with the density of blast cell percentage in the marrow(r=0.515,p=0.008) unlike the relation with total leucocyte count (r=0.364,p=0.074). Conclusion: A good clinical clue to intractable resistant course of the disease at diagnosis is verified in this study when very high level of Bcl-2 protein carrying cells was found. This finding may have a useful clinical application through the recommendation to change therapeutic strategy, at time of diagnosis, to more aggressive protocols, which is agreed by others. There was no chance to study the application of high level of Bcl-2 protein in terms of long-term survival due to short follow up.


Article
The Significance of Estimation of Anti- Apoptotic Protein in Acute Leukemia Cases

Authors: Waseem Fadhil Al-Tememi --- Aladdin M. Al- Qasim --- Haider Sabbah
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2008 Volume: 7 Issue: 2 Pages: 53-58
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Apoptosis is a terminal cell fate that eliminates physiological unneeded or dangerous cells. The Bcl-2 oncoprotein encodes a mitochondrial protein that blocks apoptosis. High levels of Bcl-2 protein are found in different malignancies including acute leukemias and it is thought to be directly involved in the emergence of drug resistance by disrupting &/or delaying apoptotic program and promoting tumor survival. Objectives: To analyze the significance of any variation in the level of Bcl-2 expression according to disease progress (from time of diagnosis to time of remission or resistance) in cases with acute leukemia, and whether to consider this variation as a prognostic marker.Methods: Through a prospective study, 25 samples of bone marrow aspirates were taken from different patients who attended the hematology unit of Baghdad teaching hospital in the medical city from December 2005 to July 2006, who proved to have acute leukemia in its different types or subtypes(ALL and AML) & at a variable phases of the disease course. Monoclonal antibody targeted against Bcl-2 oncoprotein via immunocytochemistry staining techniques of these aspirates was performed in order to define the level of Bcl-2 protein carrying cells &looking for any differences in this expression in relation to disease progress or treatment hoping to translate these findings in terms of prognosis.Results: Despite the heterogenous expression of Bcl-2 protein carrying cells in each case(0-500 cells out of 500 cells)of AML or ALL , it was found to be in positive correlation with the density of blast cell percentage in the marrow(r=0.515,p=0.008) unlike the relation with total leucocyte count (r=0.364,p=0.074). Conclusion: A good clinical clue to intractable resistant course of the disease at diagnosis is verified in this study when very high level of Bcl-2 protein carrying cells was found.This finding may have a useful clinical application through the recommendation to change therapeutic strategy, at time of diagnosis, to more aggressive protocols, which is agreed by others.There was no chance to study the application of high level of Bcl-2 protein in terms of long-term survival due to short follow up.

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