@article{3080696,
    title = "Combined expression of p53, bel-2, and p21(WAF-1) proteins in lung
cancer and premalignant lesions: Association with clinical
characteristics",
    author = "Kalomenidis, L and Orphanidou, D and Papamichalis, G and and Vassilakopoulos, T and Skorilas, A and Rasidakis, A and Papastamatiou, H and and Jordanoglou, J and Roussos, C",
    journal = "Lung Cancer",
    year = "2001",
    volume = "179",
    number = "5",
    pages = "265-278",
    publisher = "Springer-Verlag",
    issn = "0169-5002",
    doi = "10.1007/s0040800000067",
    keywords = "lung cancer; immunohistochemistry; preneoplastic; p53; Bcl-2; p21(WAF-1)",
    abstract = "We examined p53, p21(WAF-1), and Bcl-2 protein expression in malignant
and nonmalignant bronchial specimens obtained during bronchoscopy from
60 lung cancer patients. Twenty-six (43.3%), 36 (60%), and 20 (33.3%)
of the tumors were p53, p21(WAF-1), and Bcl-2 positive, respectively.
High-level p53 and Bcl-2 expression characterized advanced preneoplastic
lesions, while hyperplasias, squamous metaplasias, and mild dysplasias
exhibited low levels of expression. There was no difference between
early and advanced preneoplastic lesions in the level of p21(WAF-1),
expression. A history of heavy smoking was associated with p21(WAF-1),
expression in preneoplastic lesions (P = 0.022) and tumors (p = 0.032).
p53(-)/p21(WAF-1)(+ +)/bcl-2(-) was the only significant independent
predictor of lower clinical stage (OR: 0.88, p = 0.038). In univariate
analysis, survival of NSCLC patients was affected by disease stage (p <
0.001) and tumor histology (p = 0.018). While single-protein expression
was not associated with prognosis, the combined immunophenotype
p53(-)/p21(WAF-1)(+ +)/bcl-2(-) predicted longer survival 67 = 0.03). In
multivariate analysis, only the TNM stage was found to be a prognostic
factor for NSCLC. We conclude that p53 and Bcl-2 alterations may happen
early in bronchial carcinogenesis and that absence of these alterations
in combination with p21(WAF-1), overexpression may be associated with a
less aggressive tumor behavior."
}