Objective:TheexpressionofB-celllymphoma2(Bcl-2)seemstobeinfluencedbytheendocrineenvironment.NumerousreportsdemonstratetheperseexpressionofBcl-2familymembersundersexsteroidregulation.Withtheexceptionofestrogen-relatedtumors,androgen-relatedtumorshaveshowntheircharacteristicsinBcl-2expression.Inthisstudy,thestatusofBcl-2expressioninmalehepatocellularcarcinoma(HCC)patientswasexaminedtoverifythehighincidenceofHCCinmales.Methods:TumortissuemicroarraywasusedtoexamineBcl-2expressionlevelsin374HCCcasesincluding306malesand68females.Kaplan-Meiermethod,log-ranktest,andCoxproportionalhazardsmodelwereappliedtoinvestigatethepredictivevalueofBcl-2inHCCpatients.Results:ImmunohistochemistryanalysisshowedthatmalepatientswithhigherBcl-2levelshadsignificantlylongermediansurvivaltimeandrecurrencetimethanthosewithlowerlevels.However,nosignificantdifferencesinoutcomeswerefoundbetweendifferentBcl-2levelsinfemalepatients.Whenthemalepatientswerestratifiedintoseveralagepoints,thelevelofBcl-2expressionshowedpoorerpredictiveefficiencyinthe45–49and55–60agegroupsinandropause-agepatientscomparedwithotheragegroups.Bcl-2wasanindependentprognosticfactorforbothoverallsurvival(P<0.0001)andrecurrencetime(P=0.0001)inmalepatients.Afterexcludingmalepatientsinthe45–60agegroup,thepredictiveefficiencywasenhanced(n=147,OS,P=0.0002,TTR,P<0.0001).Conclusions:Bcl-2expressionisanindependentpredictorofsurvivalandrecurrenceinmaleHCC.Bcl-2levelsmayalsoberegulatedbyandrogensorandrogenreceptorsinmaleHCCpatients.Bcl-2levelschangeandexhibitpoorpredictiveefficiencywhenandrogenlevelsvarydramatically(andropauseage).
