Colorectal carcinoma (CRC) is the third leading cause of cancer-related deaths in the United States, in Egypt, CRC is third most commonly diagnosed cancer in males and second in females. Approximately one-half of colorectal carcinoma patients already have metastases at the time of diagnosis. Apoptosis is a form of cell death which is regulated at gene level and plays a central role in neoplastic transformation main group of genes controlling apoptosis is bcl family, which includes both promoters and inhibitors, anti-apoptotic protein Bcl-x seems to play major role in colorectal tumorigenesis and progression, a shift from expression of bcl-2 to Bcl-x has been demonstrated during progression of colorectal tumors, and significant Bcl-x overexpression has been found in many cancer patients when compared with corresponding normal tissue, elevated expression of cyclooxygenase-2 (COX-2), the inducible isoform of prostaglandin H synthase, has been found in several human cancers, including colorectal cancer (CRC), this appears as rationale for the chemo-preventive effects of non-steroidal anti-inflammatory drugs in CRC. However, relation between Bcl- x and COX-2 expression from adenomas to carcinomas on one side and their relation to patient’s outcome in colorectal carcinoma cases is not fully understood.
Purpose of current study was to investigate role of BCL-X and COX-2, and mean apoptotic bodies in progression from colorectal adenomas to adenocarcinomas as well as to assess their prognostic significance in patients with colorectal carcinoma.
PATIENTS AND METHODS: Tissue biopsies were taken from paraffin-embedded tissue blocks of 90 cases including 10 normal non-neoplastic mucosae, 10 cases of colorectal adenomas, and 70 colorectal carcinomas; using immunohistochemical technique, antibodies against BCL-X, and COX-2.were applied to stain tissue biopsies used in this study, mean apoptotic bodies were counted on the H&E stained slides of colorectal adenoma and carcinoma cases.
RESULTS: statistically significant correlations were found between Bcl-x, Cox-2 expressions and mean apoptotic bodies with different clinicopathological variables mainly tumor type, tumor grade, distant metastasis, and patient survival.
CONCLUSIONS:
In conclusion, increased Bcl-x and Cox-2 may be integrated in colorectal carcinogenesis, their expression is increased from colorectal adenomas to colorectal adenocarcinomas as well as they can play prognostic role in colorectal carcinogenesis and incorporated as good predicators for patient’s outcome. On basis of these results, it is possible to suggest Bcl-x, Cox-2 as markers of poor prognosis. The increased expression of Bcl-x, Cox-2 and could constitute a hallmark of aggressive biological behavior in colorectal carcinomas.
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