BCL2 and P53 immunoexpression in colorectal carcinoma


  • Tenya Tariq Abdulhameed Department of Pathology, College of medicine, Hawler Medical University, Erbil, Iraq.
  • Salah Abubakir Ali Department of Pathology, College of medicine, Hawler Medical University, Erbil, Iraq.




Colorectal carcinoma, BCL2, P53


Background and objective: The products of BCL2 and P53 genes are involved in the regulation of proliferation and apoptosis and have been associated with prognosis in several malignancies, including colorectal carcinoma. This study aimed to investigate the expression of antiapoptotic BCL2 protein in colorectal carcinoma and to examine its association with one of the important mediators of apoptosis (P53 protein) and with clinicopathological factors, and to assess the prognostic value of the combined BCL2 /P53 phenotypes by studying their relation with the two most important prognostic factors of grading and staging. Methods: A retrospective and prospective study was carried out from the period of August 2010 to June 2011. Sixty eight formalin-fixed, paraffin-embedded blocks of colorectal carcinoma cases were evaluated regarding BCL2 expression, P53 nuclear accumulation and their concomitant expression using immunohistochemistry by Dako Cytomation.LSAB + System-HRP. Results: The study shows that 29.41% of the colorectal tumors were positive for BCL2 protein expression and associated with earlier stage tumors (P = 0.021), while 72.06% were positive for P53 protein expression and associated with later stage tumors (P = 0.006) and male gender (P = 0.005). There was a trend toward an inverse correlation between BCL2 and P53 expression (P = 0.0013). Tumors that did not express detectable levels of BCL2 but exhibited nuclear accumulation of P53 were most common and associated with later stage tumors (P = 0.003). Conclusion: Concomitant assessment of both BCL2 and P53 status may be valuable in predicting the aggressiveness of tumors in patients with colorectal carcinomas.


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Jemal A, Siegel R, Ward E, Hao P, Xu Q, Murray T, et al. Cancer Statistics.CA Cancer J Clin 2008; 58:71-96.

Bisgaard M. Young age colorectal cancer and identification of hereditary nonpolyposis colorectal cancer cohorts. Br J Surg 2007; 94: 1055-6.

Bakhshi A, Jensen P, Goldman P, Wright J, McBride W, Epstein L, et al. Cloning the chromosomal breakpoint of t(14;18) human lymphomas: clustering around JH on chromosome 14 and near a transcriptional unit on 18. Cell 1985; 41: 889–906.

Cryns V, Yuan J. Proteases to die for. Genes Dev 1998; 12: 1551–70.

Graziano F, Cascinu S. Prognostic molecular markers for planning adjuvant chemotherapy trials in Dukes' B colorectal cancer patients: how much evidence is enough? Ann Oncol 2003; 14: 1026–38.

Wu X, Chen V, Martin J. Subsite-specific colorectal cancer incidence rates and stage distributions among Asians and Pacific Islanders in the United States, 1995 to 1999. Cancer Epidemiol Biomarkers Prev 2004;13:1215-22.

World Health Organization. International histological classification of tumors. Volume 15. Histological typing of intestinal tumors. Geneva: World Health Organization; 1976.

Washington K, Berlin J, Branton A. Protocol for the examination of specimens from patients with primary carcinomas of the colon and rectum. Arch Pathol Lab Med 2008; 132:1182-93.

Edge S, Byrd R, Carducci. AJCC Cancer Staging Manual. 7th ed. New York NY: Springer; 2009.

Ismail H, El-Baradie M, Moneer M, Khorshid O, Touny A. Clinico-Pathological and Prognostic Significance of P53, BCL2 and Her-2/neu Protein Markers in Colorectal Cancer Using Tissue Microarray. Journal of the Egyptian Nat. Cancer Inst 2007; 19: 3-14.

Watson N, Madjd Z, Scrimegour D, Spendlove I, Ellis I, Scholefield J, et al. Evidence that the P53 negative / BCL2 positive phenotype is an independent indicator of good prognosis in colorectal cancer: A tissue microarray study of 460 patients. World J Surg Oncol 2005; 3:47.

Han S, Park M, Hwang S. Differential expression of BCL2, Bcl-XL and P53 in colorectal cancer. J Gastroenterol Hepatol 2006; 21(7): 1108-14.

Tsutsui S, Yasuda K, Suzuki K, Takeuchi H, Nishizaki T, Higashi H, et al. BCL2 protein expression is associated with P 27 and P53 protein expressions and MIB-1 counts in breast cancer. BMC Cancer 2006; 6: 187–93.

Elkablawy A, Maxwell P, Williamson K, Anderson N, Hamilton W. Apoptosis and cell-cycle regulatory proteins in colorectal carcinoma: relationship to tumour stage and patient survival. J Pathol 2001; 194: 436–43.

Tzouvala M , Lazaris A , Papatheodoridis G , Kouvidou CH, Papathomas TH , Kavantzas N, et al . Potential Role of Apoptosis and Apoptotic Regulatory Proteins in Colorectal Neoplasia: Correlations with Clinico-Pathological Parameters and Survival. Dig Dis Sci 2008; 53:451–60.

Geske J, Gerschenson E. The biology of apoptosis. HumPathol 2001; 32: 1029–38.

Lustosa A, Logullo A, Artigiani R, Saad S, Goldenberg A, Matos D. Analysis of the correlation between P53 and BCL2 expression with staging and prognosis of the colorectal adenocarcinoma.Acta Cirúrgica Brasileira 2001;20 (5): 353-7.

Hao P, Frayling M, Sgouros G, Du Q, Willcocks C , Talbot C, et al. The spectrum of P53 mutations in colorectal adenomas differs from that in colorectal carcinomas. Gut 2002; 50: 834–9.

Goussia C, Ioachim E, Agnantis J, Mahera M, Tsianos V. BCl2 expression in colorectal tumours. Correlation with P53, mdm-2, Rb proteins and proliferation indices. Histol Histopathol 2000; 15: 667–72.




How to Cite

Abdulhameed, T. T., & Ali, S. A. (2014). BCL2 and P53 immunoexpression in colorectal carcinoma. Zanco Journal of Medical Sciences (Zanco J Med Sci), 18(2), 751–755. https://doi.org/10.15218/zjms.2014.0028



Original Articles