硒对亚硝酸钠导致的草鱼肝细胞氧化损伤的保护作用

以草鱼(Ctenopharyngodon idella)肝细胞(L8824)为研究对象, 设置对照组、亚硝酸钠暴露实验组、亚硒酸钠孵育实验组和亚硒酸钠孵育后亚硝酸钠暴露实验组, 探讨亚硒酸钠对不同浓度亚硝酸钠诱导L8824细胞氧化损伤及凋亡的保护作用。结果显示, 亚硝酸钠暴露能抑制L8824细胞贴壁, 导致细胞凋亡率增加。亚硝酸钠暴露引致L8824细胞的谷胱甘肽过氧化物酶(GPX)、超氧化物歧化酶(SOD)和过氧化氢酶(CAT)活性降低; gpx、sod和cat基因表达下调(P<0.05), DNA损伤诱导转录物3(ddit3)和bcl-2相关X蛋白(bax)基因表达上调(P<0.05)。亚硒酸钠(10 μmol/L)孵育L8824对细胞形态和凋亡率无显著影响, 但GPX、SOD和CAT活性上升, gpx、sod、cat、核因子E2相关因子2(Nrf2)和Kelch样环氧氯丙烷相关蛋白-1(keap1)基因表达上调(P<0.05)。亚硒酸钠孵育后亚硝酸钠暴露实验组, 细胞凋亡率、GPX、SOD和CAT活性较对照组无显著变化, 但B淋巴细胞瘤-2(bcl-2)基因表达显著上调(P<0.05)。研究结果表明, 给草鱼肝细胞补充硒在一定程度上能缓解亚硝酸钠暴露导致的抗氧化系统失衡, 抵抗亚硝酸钠暴露带来的氧化应激, 降低细胞凋亡率, 硒的预孵育作用能上调Nrf2/Keap1通路中的关键基因和酶, 表明硒的保护作用可能是通过介导 Nrf2/Keap1信号通路发挥作用。     

SLE患者PBMC凋亡状态及相关基因表达的研究

探讨外周血单个核细胞(PBMC)凋亡及其基因调控在系统性红斑狼疮(systemic lupus erythematosus,SLE)发病机制中的作用.用流式细胞仪(FCM)检测PBMC凋亡百分率及T细胞亚群的凋亡状态;用RT-PCR检测PBMC bcl-2和bax的mRNA表达;用FCM检测凋亡相关基因bcl-2,bax,fas,p53和c-myc的蛋白表达.结果显示,SLE患者PBMC凋亡百分率明显高于正常人,且活动期患者高于非活动期患者.SLE活动期患者CD4+,CD8+T细胞数明显低于正常人;非活动期患者CD8+T细胞数明显低于正常人,而CD4+T细胞数与正常人比较无统计学差异;SLE患者PBMC bcl-2和bax mRNA表达与正常人比较无统计学差异;SLE患者PBMC bcl-2,bax和fas蛋白表达明显高于正常人,p53和c-myc蛋白表达在各组之间无统计学差异.SLE患者PBMC凋亡百分率增高、外周血T细胞亚群的异常及bcl-2,bax和fas蛋白表达增高,在SLE发病机制中可能起了一定的作用.     

氧化应激对原代培养乳鼠心房肌细胞中内质网应激及凋亡因子的影响

目的：研究氧化应激对原代培养乳鼠心房肌细胞凋亡、内质网应激及凋亡因子的影响。方法：实验分2组：对照组、氧化应激组。原代培养乳鼠心房肌细胞,氧化应激组在培养的原代心房肌细胞中加入终浓度为100μmol/L的H₂O₂培养2 h,检测氧化和抗氧化指标超氧化物歧化酶（SOD）活力、丙二醛（MDA）及还原型谷胱甘肽（GSH）含量;检测细胞凋亡、细胞GRP78、GRP94及chop、bax、bcl-2 mRNA表达。结果：与对照组相比较,氧化应激组心房肌细胞SOD活力和GSH含量下降、MDA含量增加（P < 0.01）,细胞凋亡增加（P < 0.01）,细胞GRP78、GRP94、chop、bax mRNA表达增加、bcl-2 mRNA表达减少（P < 0.01）。结论：氧化应激反应可能介导内质网应激反应并激活促凋亡因子表达,抑制抗凋亡因子表达,引起心房肌细胞凋亡增加。这可能与心房纤颤的发生有一定关联性。     

大鼠颈部淋巴引流阻断后海马bcl-2、bax表达和细胞凋亡的动态变化

为了研究淋巴滞留性脑病中海马bcl-2、bax基因表达和细胞凋亡的动态变化,本实验用阻断大鼠颈部淋巴引流的方法制备淋巴滞留性脑病模型,术后1、2、3、5、7和14d处死动物,H&E染色观察海马组织结构变化,TUNEL荧光标记检测原位细胞凋亡,RT-PCR检测海马bcl-2和bax的mRNA表达。结果显示脑组织有水肿的结构变化,第5天最明显。海马TUNEL阳性细胞数从术后2d开始增多,5d达最高值。bax表达于术后1d开始增高,第2天即达最高值。bcl-2表达于术后1d开始降低,5d达最低值。第14天上述指标均恢复到对照组水平。研究表明,阻断颈部淋巴引流所导致的淋巴滞留性脑病中海马bcl-2和bax的表达发生变化,而且海马神经细胞的死亡以凋亡为主。     

法舒地尔对急性心肌梗死大鼠心肌组织中Rho激酶的影响及心肌保护作用(英文)

目的:分析急性心肌梗死(AMI)后大鼠心肌组织Rho激酶表达的变化及心肌细胞凋亡情况,观察法舒地尔对急性心肌梗死(AMI)后大鼠心肌组织Rho激酶表达的影响,探讨法舒地尔对心梗后心肌的保护作用。方法:选取雄性Wistar大鼠,随机分为三组:治疗组、AMI组、假手术组。治疗组及AMI组均结扎左前降支(LAD)制作AMI模型;假手术组只在其LAD下穿线不结扎。治疗组给予法舒地尔5mg/kg,腹腔注射,每日两次;对照组和假手术组给予等量生理盐水。1周后,EvensBlue及NBT双染色确定缺血面积及梗死面积,RT-PCR法测定rho激酶mRNA的表达,DNA断裂的原位末端标记法(T UNEL法)检测缺血区心肌细胞凋亡指数(AI),免疫组化测定凋亡相关蛋白bcl-2及bax表达的变化。结果:1周后,AMI组与假手术组相比,AMI组大鼠Rho激酶mRNA表达增加(P0.01),凋亡相关蛋白bax表达增加(P0.01),bcl-2表达减少(P0.01),AI明显增加(P0.01)。治疗组与AMI组相比,梗死面积显著减小(P0.05),Rho激酶mRNA及bax表达显著减少,AI显著降低,bcl-2表达显著增加(均P0.01)。结论:大鼠AMI后,心肌组织中Rho激酶的表达增加,心肌细胞凋亡指数增加,连续应用法舒地尔1周能有效减少心肌细胞凋亡指数,起到心肌保护的作用。     

人类巨细胞病毒感染树鼩原代真皮成纤维细胞诱导凋亡特性

人类巨细胞病毒(HCMV)流行广泛,危害严重,由于其严格的物种特异性限制,动物模型缺乏,严重阻碍了对其致病机制的研究及药物、疫苗的研发。本研究对树鼩(Tupaia belangeri)来源的原代真皮成纤维细胞感染HCMV后的细胞死亡现象进行了初步探索。首先,观察了感染后细胞病变和死亡情况,使用细胞增殖检测试剂盒测定了细胞活力;其次,对凋亡相关因子bax、bcl-2和未折叠蛋白反应相关因子chop、atf4、xbp1s转录水平的差异进行了逆转录荧光定量PCR检测与分析;然后利用免疫蛋白印迹技术检测并分析了主要病毒蛋白IE1、UL44和凋亡相关因子Bax、Caspase-9、Caspase-3、PARP的表达水平;最后结合膜联蛋白-V和碘化丙啶双染色法从生物化学角度对细胞死亡类型进行了鉴定。结果显示,细胞病变和死亡情况随着感染进程逐渐严重,细胞活力下降明显(P 0.001)。感染上调bax、bcl-2、chop、atf4、xbp1s转录水平并且使bax与bcl-2转录水平呈明显拮抗趋势;感染同时上调Bax、Caspase-9、Caspase-3、PARP蛋白表达和逐级剪切激活;病毒蛋白IE1、UL44可以上调至一个完整的病毒复制周期结束。综上,本研究指出HCMV跨物种感染树鼩原代真皮成纤维细胞可诱导细胞凋亡,并且与内质网和线粒体密切相关。     

白藜芦醇对猪前体脂肪细胞凋亡的作用及机理

旨在研究白藜芦醇对猪前体脂肪细胞凋亡的作用,探讨其分子机制。以50 μmol/L、100 μmol/L、200 μmol/L、400 μmol/L白藜芦醇处理猪前体脂肪细胞,采用Hoechst 33258染色剂染色,光学和荧光显微镜分别观察细胞的形态学变化。semi-qRT-PCR和Western blotting方法检测凋亡相关基因sirt1、caspase-3、bcl-2、bax、p53、NF-κB的mRNA和蛋白的表达变化。结果表明,白藜芦醇处理后,前体脂肪细胞出现明显的细胞凋亡,伴随细胞体积缩小,染色质凝集,核质固缩等特征显现,与对照组相比200 μmol/L处理组细胞的凋亡率显著升高 (P＜0.05)。凋亡相关基因sirt1、caspase-3和bax的mRNA和蛋白表达水平显著上调 (P＜0.05),而bcl-2、p53、NF-κB等基因的表达水平明显下调 (P＜0.05)。进一步证实白藜芦醇特异性地增加sirt1的表达活性,而sirt1的上调影响caspase-3和bcl-2家族因子的活性,同时参与调控p53和NF-κB的转录表达。因此,推测sirt1调控凋亡相关因子表达是白藜芦醇诱导前体脂肪细胞凋亡的关键原因。     

大肠杆菌诱导U937细胞凋亡过程中bcl-2和bax基因的表达

目的研究bcl-2和bax在大肠杆菌诱导U937细胞凋亡中的作用。方法U937细胞的凋亡用AnnexinV-FITC/PI染色流式细胞仪技术测定。Bcl-2和bax基因表达用RT-PCR法测定。结果当细胞与细菌浓度比分别为0,1:5,1:10,1:20,1:50及1:100时作用30min均可诱导U937细胞凋亡,凋亡率分别为3·16%±0·90%,9·46%±0·84%,17·90%±1·41%,35·59%±3·76%,38·35%±7·12%和55·07%±5·82%,呈浓度依赖性。在细胞凋亡过程中bcl-2和bax的表达均呈现趋势变化,bax表达逐渐增强,bcl-2表达逐渐减弱。结论E.coli可诱导U937细胞凋亡;其机制涉及bcl-2表达下调和bax表达上调。     

干细胞相关因子在子宫内膜息肉中的表达

探讨ipo13、c-kit、CD146、bcl-2和bax在子宫内膜息肉(endometrial polyp,EP)和正常内膜组织中的表达差异及临床意义。收集本院2010年3-7月行宫腔镜手术取得的40例子宫内膜息肉(病例组)与40例正常内膜组织(对照组)。采用实时荧光定量PCR技术(RT-PCR)检测ipo13、c-kit、bcl-2和bax mRNA的表达;免疫组织化学S-P法检测ipo13、CD146、bcl-2和bax蛋白的表达。无论在月经周期的增生期或分泌期,EP中ipo13、c-kit、CD146和bax mRNA和蛋白的表达均低于同期正常子宫内膜组织,差异有统计学意义(P<0.05),bcl-2均比同期正常子宫内膜增加,差异有统计学意义(P<0.05)。子宫内膜干/祖细胞活性异常和子宫内膜凋亡减少与子宫内膜息肉发病有关,其中子宫内膜干/祖细胞活性异常使内膜凋亡减少可能是EP发病的主要因素。     

腺苷受体激动剂对心肌缺血再灌注损伤大鼠内质网应激的影响及其作用机制研究

目的:探讨腺苷受体激动剂对心肌缺血再灌注损伤(MIRI)大鼠内质网应激(ERS)的影响及其作用机制。方法:选取雄性成年Wistar大鼠56只,利用Langendorff装置制成大鼠离体心脏MIRI模型。随机分为四组(n=14):假手术组(Sham组)、心肌缺血再灌注组(MIRI组)、腺苷受体激动剂组(NECA组)和内质网应激抑制剂组(TUDCA组)。利用透射电镜观察四组心肌超微结构的变化;免疫组化观察心肌肌醇依赖酶1α(IRE1α)的表达情况;Western blot方法检测心肌ERS中IRE1-XBP1信号通路标志蛋白IRE1α、X盒结合蛋白1s(XBP1s)的表达水平;TUNEL检测心肌细胞凋亡情况。结果:透射电镜结果显示,Sham组肌丝排列规则致密,嵴排列整齐,外膜和肌节形态完整;MIRI组大部分肌丝断裂,肌节挛缩变形,嵴排列稀疏结构破坏,间隙增宽,可见线粒体空泡变性;NECA组及TUDCA组较MIRI组损伤减轻,内质网轻度扩张或者正常,肌丝排列较整齐。免疫组化结果发现,Sham组心肌纤维呈细长圆柱形,形态正常,少量结缔组织存在,基本无IRE1α阳性染色;MIRI组细胞排列紊乱,有许多断裂的细胞出现,IRE1α阳性染色区域显著增加,而NECA和TUDCA组细胞病理的变化较轻,相对于MIRI组,IRE1α阳性染色部位明显减少。Western blot结果显示,与Sham组相比,MIRI组的IRE1α和XBP1s蛋白的表达水平明显上升(P0.05);而与MIRI组相比,TUDCA组及NECA组IRE1α和XBP1s的蛋白表达水平显著降低(P0.05)。TUNEL结果显示,MIRI组细胞凋亡明显,Sham组基本没有发生心肌细胞凋亡,MIRI组较NECA组及TUDCA组的凋亡细胞数更多。结论:NECA可通过抑制IRE1-XBP1信号通路来减轻ERS反应,达到保护心肌组织细胞的目的。     

Annexin 1 protects against apoptosis induced by serum deprivation in transformed rat retinal ganglion cells

To investigate whether Annexin 1 can protect a retinal ganglion cells line (RGC-5) from apoptosis as induced by serum deprivation. Annexin 1 location in RGC-5 cells was determined using an indirect immunofluorescent assay. Expression of Annexin 1 in RGC-5 cultures deprived of serum for 0, 2 days was semi-quantified by western blot and RT-PCR. Effects of varying concentrations of the Annexin 1 peptide fragment, Ac2-26, on the survival of the RGC-5 cells was determined, and apoptotic cells were quantified by flow cytometry. Immunoblot and RT-PCR analysis was preformed to identify caspase 3, bax and bcl-2 in RGC extracts. Annexin 1 was localized in the cytoplasm of RGC-5 cells and the expression of Annexin 1, caspase 3 and bax was upregulated in serum-deprived RGC-5 cells. Ac2-26 attenuated the apoptosis resulting from serum deprivation of RGC-5 in a concentration-dependent manner, decreased caspase 3 and bax levels and produced an increase of bcl-2 in cell lysates. Annexin 1, in specific the peptide fragment Ac2-26, may play an important role in decreasing apoptosis in serum-deprived RGC-5 cells.     

Blockage of TRPM7 channel induces hepatic stellate cell death through endoplasmic reticulum stress-mediated apoptosis

Aims

Proliferation is a ‘multiplier’ for extracellular matrix production and contraction of activated hepatic stellate cells (HSC) in fibrotic liver. Transient receptor potential melastatin-like 7 channels (TRPM7) are implicated in the survival and proliferation of several kinds of cells. This study was aimed to investigate the effect of TRPM7 blocker 2-APB on survival and proliferation of HSC and the underlying mechanisms.

Main methods

Rat HSC were stimulated by 2-APB for 24 h and then collected for further use. Cell viability was detected by MTT, and apoptosis was determined by AnnexinV/PI staining and TUNEL assay. Gene expressions of TRPM7, α-SMA, bcl-2, bax, and endoplasmic reticulum (ER) stress key members CHOP, caspase-12, ATF4, ATF6, Xbp1, GRP78 and calnexin were evaluated with quantitative RT-PCR. Quantifications of α-SMA, TRPM7, CHOP and GRP78 proteins were carried out by Western blot. Transmission electron microscopy and Xbp1 mRNA splicing analysis were also used for detection of ER stress.

Key findings

2-APB decreased TRPM7 and α-SMA expressions in primary HSC, and inhibited proliferation of activated HSC in a dose-dependent manner. 2-APB also decreased total count of activated HSC and increased the number of apoptotic cells. 2-APB increased expressions of bax and ER stress key factors CHOP, caspase-12, ATF4, ATF6, Xbp1, GRP78 and calnexin. Meanwhile, ultra-structural ER changes and spliced Xbp1 mRNA were also observed in 2-APB treated HSC.

Significance

Blockage of TRPM7 could inhibit activation and proliferation of primary HSC and induce apoptotic death of activated cells, in which ER stress was identified as one of possible underlying molecular bases.     

乳酸堆积和二氯乙酸钠对肝癌细胞凋亡及bax、bcl-2 表达 和caspase-3 活性的影响

目的：探讨乳酸堆积和二氯乙酸钠(DCA)对肝癌细胞(HepG2)凋亡和bax、bcl-2 表达及caspase-3 活性的影响。方法：通过体 外培养HepG2,建立稳定的体外培养模型,配制成终浓度分别为0 mmol/L、1.0 mmol/L、2.0 mmol/L、4.0 mmol/L、8.0 mmol/L的乳 酸培养液以及在不同浓度乳酸组中加入终浓度为10-3mmol/L DCA 培养液与HepG2共同培养,其中以0 mmol/L 乳酸组为对照 组。采用MTT法检测乳酸对HepG2 的抑制率,流式细胞仪检测乳酸和DCA 对HepG2的凋亡百分率,用Real-time PCR法测定 bax 及bcl-2 mRNA的表达,用免疫荧光法检测caspase-3 的活性。结果：乳酸对HepG2 的IC50值为13.6 mol/L,与对照组比较,随 着乳酸浓度的增加,HepG2 凋亡率增加,bax mRNA 表达升高,bcl-2 mRNA 的表达降低,caspase-3活性增加,其中1.0 mmol/L 乳 酸组与对照组比较(P>0.05),2.0 mmol/L,4.0 mmol/L 和8.0 mmol/L乳酸组与对照组比较差异有统计学意义(P<0.05)。加入DCA 后,HepG2 凋亡减少,2.0 mmol/L 乳酸+DCA 组、4.0 mmol/L乳酸+DCA 组、8.0 mmol/L乳酸+DCA 组与同浓度的乳酸组比较, bax mRNA 表达减少（P<0.05）,bcl-2 mRNA 表达增加（P<0.05）,caspase-3 活性减低（P<0.05）。结论：乳酸可诱导HepG2凋亡,且随 着乳酸浓度的增高,HepG2 的凋亡率增加,其机制可能是通过对bcl-2 及bax mRNA 表达的改变以及激活caspase-3 活性而实现, DCA可以降低HepG2 凋亡,对乳酸堆积造成的HepG2凋亡有抑制作用。     

Bcl-2: bax and bcl-2: Bcl-x ratios by image cytometric quantitation of immunohistochemical expression in ovarian carcinoma: correlation with prognosis

Bcl-2 is a proto-oncogene which is involved in prolonging cell survival by inhibiting programmed cell death. Bax and bcl-x are members of the bcl-2 family; when overexpressed, they can counteract the ability of bcl-2 to inhibit apoptosis. This suggests a model in which the ratios of bcl-2 to bax and bcl-x can be used to determine response to therapy and prognosis. The expression of bcl-2, bax and bcl-x was studied in 50 ovarian carcinomas. The percentage of positive area immunostained (PPA) in the nucleus and cytoplasm of each ovarian carcinoma was quantitated in 15 high power fields by image cytometry. The ratios were obtained by dividing the PPA of bcl-2 by the PPA of bax and bcl-x. 17 of 50 ovarian carcinomas (34%) stained positively for bcl-2, 39 for bax (78%) and 47 for bcl-x (94%). Although there is no significant statistical correlation between expression of bcl-2, bax or bcl-x and grade (P = 0.15; P = 0. 47; P = 0.56), stage (P = 0.71; P = 0.6; P = 0.42), and overall or disease-free survival (P = 0.26; P = 0.55; P = 0.16), increased bcl-2 expression was demonstrated in patients with shortened overall and disease-free survival. Also, increased expression of bax and bcl-x was associated with increased overall and disease-free survival. Bcl-2:bax and bcl-2:bcl-x ratios less than 1 are associated with survival advantage, although not statistically significant (P = 0.83; P = 0.93). Image cytometric measurement of bcl-2, bax, and bcl-x expression is feasible. There is a tendency for their expression to correlate with prognosis in ovarian carcinomas.     

Nigella sativa oil attenuates chronic nephrotoxicity induced by oral sodium nitrite: Effects on tissue fibrosis and apoptosis

Objectives: Sodium nitrite, a food preservative, has been reported to increase oxidative stress indicators such as lipid peroxidation, which can affect different organs including the kidney. Here, we investigated the toxic effects of oral sodium nitrite on kidney function in rats and evaluated potential protective effects of Nigella sativa oil (NSO).

Methods: Seventy adult male Sprague–Dawley rats received 80?mg/kg sodium nitrite orally in the presence or absence of NSO (2.5, 5, and 10?ml/kg) for 12 weeks. Morphological changes were assessed by hematoxylin and eosin, Mallory trichome, and periodic acid–Schiff staining. Renal tissues were used for measurements of oxidative stress markers, C-reactive protein, cytochrome C oxidase, transforming growth factor (TGF)-beta1, monocyte chemotactic protein (MCP)-1, pJNK/JNK, and caspase-3.

Results: NSO significantly reduced sodium nitrite-induced elevation in serum urea and creatinine, as well as increasing normal appearance of renal tissue. NSO also prevented reductions in glycogen levels caused by sodium nitrite alone. Moreover, NSO treatment resulted in dose-dependent significant reductions in fibrosis markers after sodium nitrite-induced 3- and 2.7-fold increase in MCP-1 and TGF-beta1, respectively. Finally, NSO partially reduced the elevated caspase-3 and pJNK/JNK.

Discussion: NSO ameliorates sodium nitrite-induced nephrotoxicity through blocking oxidative stress, attenuation of fibrosis/inflammation, restoration of glycogen level, amelioration of cytochrome C oxidase, and inhibition of apoptosis.     

爪哇伪枝藻胞外多糖诱导皮肤癌细胞(A431)凋亡的研究

为探讨爪哇伪枝藻胞外多糖(Extracellular polymeric substances of Scytonema javanicum, EPS)诱导人表皮癌A431细胞凋亡及其对凋亡相关基因caspase-3、bcl-2和bax表达的影响,本实验利用MTT法检测细胞生长抑制情况;HE染色法及透射电镜进行形态学观察;单细胞凝胶电泳法(SCGE/彗星电泳)分析DNA受损情况;免疫组织化学法检测细胞内caspase-3、bcl-2和bax表达水平。结果显示EPS能显著抑制A431细胞增殖,并呈时间和剂量依赖性,作用96h的半数抑制浓度IC50为4.25mg/mL,并出现细胞凋亡的形态学改变;彗星电泳结果与对照相比6mg/mL EPS作用48h能引起A431细胞DNA严重损伤;免疫组织化学检测发现6mg/mL EPS作用72h能显著上调A431细胞内凋亡相关基因caspase-3和bax的表达,而下调bcl-2的表达。     

Image cytometric bcl-2:bax and bcl-2:bcl-x ratios in invasive breast carcinoma: correlation with prognosis

BACKGROUND: The bcl-2 family of proteins are important regulators of apoptosis. Some of the members, such as bcl-2 and bcl-x(L), inhibit cell death, whereas others, such as bax and bcl-x(S), promote cell death. We evaluated the ratios of bcl-2:bax and bcl-2:bcl-x expression by image cytometry in invasive breast carcinoma to determine prognostic significance. DESIGN: Five-micron sections of formalin-fixed, paraffin-embedded tissue from 88 invasive breast carcinomas were immunostained using steam antigen retrieval, an avidin biotin-complex technique with automated stainer and primary antibodies against bcl-2 (1/160; Dako, Carpenteria, CA), bax (1/1,500; PharMingen, San Diego, CA), and bcl-x (1/1,500; PharMingen). Positive controls were tonsil (bcl-2) and normal breast (bax and bcl-x) tissue samples. Immunostain was measured in 15 high power fields as percentage positive area (PPA) in nuclei and cytoplasm using the CAS 200 image analyzer (Becton Dickinson, San Jose, CA). RESULTS: Median follow-up was 105 months (range 11-130). Significantly improved disease-free survival was found in patients with a bcl-2:bcl-x ratio > or = 1 by univariate and multivariate analyses. The bcl-2:bax ratio was not predictive of overall or disease-free survival. A significant difference in overall and disease-free survival was found between carcinomas with positive and negative bcl-2 expression by univariate analysis; by multivariate analysis, bcl-2 expression was an independent prognostic factor for disease-free survival. The 5-year survival rates were 77% and 50% in patients with bcl-2-positive and bcl-2-negative carcinomas, respectively. CONCLUSION: A bcl-2:bcl-x ratio > or = 1, assessed by image cytometry, is significantly associated with improved disease-free survival in patients with invasive breast carcinoma. Significantly increased overall and disease-free survival is associated with positive bcl-2 expression.