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Korean Journal of Obstetrics & Gynecology 2008;51(2):191-198.
Published online February 1, 2008.
Evaluation of apoptosis regulating genes p53, Bcl-2, Bax, and Survivin in uterine cervical cancer tissues during concurrent chemoradiotherapy: Is it possible to identify unresponsiveness to therapy? - A preliminary report.
Hyun Jin Kim, Jung Pil Lee, Jae Sun Park, Hyun Ee Lym, Hee Sug Ryu, Ki Hong Chang
1Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea. leochris@hanmail.net
2Department of Pathology, Ajou University School of Medicine, Suwon, Korea.
The objective of this study is to explore changes of the expression of apoptosis-regulating genes, p53, Bcl-2, Bax, and Survivin in cervical cancer tissues during concurrent chemoradiotherapy (CCRT). METHODS: The expressions of apoptosis-regulating genes were evaluated in 14 patients with invasive squamous cell carcinoma of the cervix, who underwent 6 cycles of CCRT using weekly cisplatin, with immunohistochemical staining and Western blot of p53, Bcl-2, Bax, Survivin. Specimens of the cervical carcinomas were obtained by punch biopsy before starting CCRT and just after 2nd and 4th cycle of weekly cisplatin. We analysed the results with clinicopathological factors of the patients. RESULTS: Among 14 patients, 2 (14.3%) patients did not respond to CCRT. In these 2 cases, p53 and Bax were not expressed before and during therapy, while the expressions of Bcl-2 and Survivin were increased. Complete response and partial response were obtained in 11 cases (78.6%) and 1 case (7.1%), respectively. In this reponse group, Bcl-2 expressiondecreased seriallyduring the treatment, but the expression ofother apoptosis-regulating genes showed no significant change. There was no correlation between the clinicopathological prognostic factors and expressions of p53, Bcl-2, Bax, and Survivin. CONCLUSION: In this preliminary study, we deduced that Bcl-2 expression might predict response of CCRT even before completing treatment. In order to establish this possibility, a large scaled study should be needed in the future.
Key Words: Apoptosis, p53, Bcl-2, Bax, Survivin, Uterine cervical cancer, Concurrent chemoradiotherapy
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