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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 28, 2008; 14(40): 6218-6223
Published online Oct 28, 2008. doi: 10.3748/wjg.14.6218
Bcl-2 expression significantly correlates with thymidylate synthase expression in colorectal cancer patients
Riyad Bendardaf, Raija Ristämaki, Kari Syrjänen, Seppo Pyrhönen
Riyad Bendardaf, Raija Ristämaki, Kari Syrjänen, Seppo Pyrhönen, Department of Oncology and Radiotherapy, Turku University Central Hospital, Savitehtaankatu 1, PB 52, Turku FIN 20521, Finland
Correspondence to: Dr. Riyad Bendardaf, Department of Oncology and Radiotherapy, Turku University Hospital, Savitehtaankatu 1, PB 52, Turku FIN-20521, Finland. riyben@utu.fi
Telephone: +358-2-3132800  Fax: +358-2-3132809
Received: November 24, 2007
Revised: July 14, 2008
Accepted: July 21, 2008
Published online: October 28, 2008
Abstract

AIM: To examine the expression of thymidylate synthase (TS) and oncoprotein Bcl-2 in advanced colorectal cancer (CRC) patients, and to determine their mutual relationship, association to therapeutic response and impact on disease outcome.

METHODS: Tumor samples from 67 patients with CRC, who were treated at advanced stage with either irinotecan alone or in combination with 5-fluorouracil/leucovorin, were analyzed for expression of TS and Bcl-2 using immunohistochemistry.

RESULTS: A significant linear correlation between lower expression levels of Bcl-2 and lower levels of TS expression was found (P = 0.033). Patients with high levels of both TS and Bcl-2 expression had a significantly longer disease-free survival (DFS) (42.6 mo vs 5.4 mo, n = 25) than those with low TS/Bcl-2 index (P = 0.001). Tumors with low levels of both TS and Bcl-2 were associated with a longer survival with metastasis (WMS) interval in the whole patients group (n = 67, P = 0.035). TS/Bcl-2 index was not significantly related to disease-specific survival.

CONCLUSION: The present data suggest that CRC patients with low TS/Bcl-2 demonstrate a significantly shorter DFS and longer WMS.

Keywords: Thymidylate synthase, Bcl-2, Colorectal cancer, Disease-free survival, Survival with metastases