Hashimoto N, Tachibana M, Dhar D K, Yoshimura H, Nagasue N
Second Department of Surgery, Shimane, Medical University, Izumo, Japan.
Ann Surg Oncol. 1999 Jul-Aug;6(5):489-94. doi: 10.1007/s10434-999-0489-2.
Cancer of the esophagus is one of the most malignant tumors and has a poor prognosis. The p53 and retinoblastoma (RB) genes are involved in the regulation of cell population by suppressing cell proliferative activity. Our goal was to clarify whether expression of p53 and RB genes could be prognostic factors in squamous cell carcinoma of the esophagus.
Tumor samples taken from 73 patients undergoing subtotal esophagectomy were immunohistochemically stained for the p53 and RB genes. An image analyzer was used for quantitative assessment of the staining, and clinicopathologic characteristics of those patients were investigated.
Patients in whom p53 expression was high had greater tumor diameter, deeper tumor invasion, and worse prognosis compared with patients in whom p53 expression was low. Patients in whom RB expression was low had a higher incidence of lymph node metastasis and more advanced disease than did those in whom RB expression was high. The combination of p53 and RB expression revealed that the cases with high p53 and low RB expression had significantly worse survival rates and deeper tumor invasion compared with other groups. In various clinicopathologic parameters, (e.g., age, sex, tumor-diameter, tumor type, location, differentiation, TNM classification, TNM stage) tumor type, tumor size, depth of invasion, lymph node involvement, distant metastasis, and combined p53 and RB expression showed significant differences in survival by univariate analysis. Among those six variables, only lymph node involvement showed an independent prognostic factor for survival (P = .0055) by multivariate analysis.
The combination of p53 and RB expression is not a prognostic indicator in the surgical treatment of esophageal cancer.
食管癌是最具恶性的肿瘤之一，预后较差。p53基因和视网膜母细胞瘤（RB）基因通过抑制细胞增殖活性参与细胞群体的调控。我们的目标是阐明p53基因和RB基因的表达是否可作为食管鳞状细胞癌的预后因素。
对73例行食管次全切除术患者的肿瘤样本进行p53基因和RB基因的免疫组织化学染色。使用图像分析仪对染色进行定量评估，并研究这些患者的临床病理特征。
与p53表达低的患者相比，p53表达高的患者肿瘤直径更大、肿瘤浸润更深且预后更差。与RB表达高的患者相比，RB表达低的患者淋巴结转移发生率更高且疾病进展更严重。p53和RB表达的联合分析显示，与其他组相比，p53高表达和RB低表达的病例生存率显著更低且肿瘤浸润更深。在各种临床病理参数（如年龄、性别、肿瘤直径、肿瘤类型、位置、分化程度、TNM分类、TNM分期）中，肿瘤类型、肿瘤大小、浸润深度、淋巴结受累情况、远处转移以及p53和RB表达的联合分析经单因素分析显示在生存率方面存在显著差异。在这六个变量中，多因素分析显示只有淋巴结受累是生存的独立预后因素（P = 0.0055）。
p53和RB表达的联合分析在食管癌手术治疗中不是预后指标。
