Ki-67, cyclin D1, p53 and bcl-2 expression in advanced head and neck cancer

In order to analyse the radiosensitivity of tumours and to evaluate the possibility of improving the treatment results with regard to genetic alterations, we examined 33 patients with advanced head and neck tumours after 66-70 Gy irradiation. Between 1998 and 2001, 33 patients with advanced head and neck squamous cell carcinoma (HN-SCC) were observed. They received 66-70 Gy to the primary tumour site and pathological lymph nodes. One month later, physical examination and CT were performed to verify the effect of radiotherapy, and the patients were followed until their death. The histological grading and Ki-67, cyclin D1, p53 and bcl-2 status were examined from the aspect of their potential prognostic value in all patients. The average survival was 13 months; 25% of the patients survived for at least 20 months. Seventy-two percent of the patients demonstrated Ki-67 positivity, 69% p53 positivity and 40% cyclin D1 positivity; there were only 12% bcl-2-positive cases. A significant correlation was not found between the tumour response or the duration of survival and the Ki-67, p53 or cyclin D1 positivity. Only bcl-2-positive cases exhibited significantly better outcome. These parameters indicate the proliferating (Ki-67 and cyclin D1) and apoptotic (p53 and bcl-2) activities of advanced HN-SCC cells. Our results proved that they proliferate rapidly and have impaired repair or apoptotic functions. The heterogeneity of our results did not allow us to conclude that the above parameters are of clinically reliable prognostic value, but the obviously high kinetic activity of HN-SCC underlines the potential efficacy and need for accelerated irradiation in these cases.