ISSN:
1437-7772
Keywords:
Key words Esophageal carcinoma
;
Chemotherapy
;
p53
;
p21
;
bcl-2
;
bax
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background. Chemotherapy is an important component of the multimodal approach to the treatment of advanced esophageal squamous cell carcinoma. Methods. We investigated the associations between p53, p21 (Waf1), bcl-2, and bax expression and response to chemotherapy (cisplatin + 5-fluorouracil + leucovorin) in 43 patients with advanced esophageal squamous cell carcinoma. The expression of p53, p21 (Waf1), bcl-2, and bax proteins was analyzed immunohistologically in pretreatment biopsy and post-treatment resected specimens. Results. The 23 patients who had objective evidence of either a complete response (CR) or a partial response (PR) to chemotherapy survived for significantly longer than the 20 patients who had no response (NR). The expression of p53, p21 (Waf1), bcl-2, and bax was detected in 26 (61%), 12 (28%), 6 (14%), and 19 (44%) of the pretreatment biopsy specimens, respectively. The response to chemotherapy was not independently associated with the expression of any of these proteins. However, in the 26 patients with p53-expressing tumors, the response rate was 80% in patients whose tumor also expressed p21, whereas it was 19% in those whose tumor did not coexpress p21. No change in p53 expression was observed before and after chemotherapy, except in 1 patient; however, p21 expression appeared to be induced by chemotherapy in 5 patients. Patient survival was also not independently associated with the expression of any of these proteins. However, patients with p53-negative or p21-positive tumors had a better response to chemotherapy and survived for longer than those with p53-positive and p21-negative tumors. Conclusion. p53 and p21 expression in biopsy specimens obtained before chemotherapy could be useful predictors of response and survival in patients with advanced esophageal squamous cell carcinoma.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s101470050097
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