Sredni S T, de Camargo B, Lopes L F, Teixeira R, Simpson A
Pathology Department, Hospital do Cancer, São Paulo, Brazil.
Med Pediatr Oncol. 2001 Nov;37(5):455-8. doi: 10.1002/mpo.1229.
Mutations of the tumor suppressor gene p53 are commonly found in several kinds of human cancer. In some types of neoplasms, accumulation of p53 protein has been reported to correlate with more aggressive clinical behavior. The role of p53 expression in Wilms tumors (WT) is not clear yet, but most studies have confirmed its correlation with anaplasia and advanced stage disease.
Ninety-seven WT were evaluated for p53 expression by immunohistochemistry in formalin-fixed paraffin-embedded tissue and correlated with outcome. Tumors were classified as p53-Negative (p53-N) when no positivity was observed or only few cells showed weak positivity (0/1+) and p53-Positive (p53-P) when there was a diffuse and strong nuclear positivity (2+/3+).
p53-P was detected in 13 out of 97 tumors and was associated with disease relapse (39 vs.17%; P = 0.06) but not with anaplasia. Among p53-N patients only 5% had metastatic disease compared with 31% of the p53-P sample. (P = 0.038). Overall survival was 94% for patients with p53-N vs. 85% for patients with p53-P at 1 year (P = 0.34).
p53 expression in Wilms tumor detected by immunohistochemistry seems to be associated with advanced disease and relapse.
肿瘤抑制基因p53的突变在多种人类癌症中普遍存在。在某些类型的肿瘤中，据报道p53蛋白的积累与更具侵袭性的临床行为相关。p53表达在肾母细胞瘤（WT）中的作用尚不清楚，但大多数研究已证实其与间变和晚期疾病相关。
采用免疫组织化学方法对97例WT患者福尔马林固定石蜡包埋组织中的p53表达进行评估，并与预后相关联。当未观察到阳性或仅少数细胞显示弱阳性（0/1+）时，肿瘤被分类为p53阴性（p53-N）；当存在弥漫性强核阳性（2+/3+）时，肿瘤被分类为p53阳性（p53-P）。
97例肿瘤中有13例检测到p53-P，其与疾病复发相关（39%对17%；P = 0.06），但与间变无关。在p53-N患者中，只有5%有转移性疾病，而p53-P样本中这一比例为31%。（P = 0.038）。p53-N患者1年总生存率为94%，而p53-P患者为85%（P = 0.34）。
通过免疫组织化学检测到的肾母细胞瘤中p53表达似乎与晚期疾病和复发相关。
