Prognostic significance of Bcl-2 in clinically localized prostate cancer

Am J Pathol. 1996 May;148(5):1557-65.


The clinical course of prostate cancer is highly variable and cannot satisfactorily be predicted by histological criteria alone. To study the prognostic significance of Bcl-2 and p53 overexpression in prostate cancer, 137 consecutive radical prostatectomy specimens were examined by immunohistochemistry. Both Bcl-2 and p53 were associated with malignant phenotype. Bcl-2 expression was more frequent in pT3 tumors (31% positive) than in pT2 tumors (5% positive, P = 0.001). p53 overexpression (found in 8%) was associated with high Gleason score (P = 0.03) and increased tumor growth fraction (Ki67 labeling index (LI); P = 0.017). Survival analysis showed that Bcl-2 expression (P = 0.03), high Ki67 LI (P = 0.018), high grade (P = 0.0037), advanced local stage (P = 0.0005), and positive lymph nodes (P = 0.026) were predictors of progression. The combined analysis of Ki67 LI and Bcl-2 allowed the distinction of three groups with different clinical outcome. Prognosis was best in Bcl-2-negative tumors with low Ki67 LI, worst in Bcl-2-positive tumors with high Ki67 LI, and intermediate in the remaining tumors (P = 0.03). These data suggest that altered expression of both Bcl-2 and p53 play a role in prostate cancer progression. Combined analysis of factors regulating both apoptosis and cell proliferation may be relevant in prostate cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Apoptosis
  • Cell Division
  • Disease Progression
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen
  • Linear Models
  • Male
  • Middle Aged
  • Neoplasm Proteins / analysis
  • Nuclear Proteins / analysis
  • Phenotype
  • Prognosis
  • Prostatic Neoplasms / chemistry*
  • Prostatic Neoplasms / pathology
  • Proto-Oncogene Proteins / analysis*
  • Proto-Oncogene Proteins c-bcl-2
  • Tumor Suppressor Protein p53 / analysis


  • Ki-67 Antigen
  • Neoplasm Proteins
  • Nuclear Proteins
  • Proto-Oncogene Proteins
  • Proto-Oncogene Proteins c-bcl-2
  • Tumor Suppressor Protein p53