Sagarra R A M, Andrade L A L A, Martinez E Z, Pinto G A, Syrjänen K J, Derchain S F M
Department of Medical Clinic (Clinical Oncology), Universidade Estadual de Campinas, São Paulo, Brazil.
Int J Gynecol Cancer. 2002 Nov-Dec;12(6):720-7. doi: 10.1046/j.1525-1438.2002.01135.x.
The study was designed to evaluate the prognostic importance of clinical and pathologic variables with p53 and Bcl-2 in epithelial ovarian cancer using multivariate analysis. Tumor tissues from 90 patients were analyzed immunohistochemically for p53 and Bcl-2 expression. Hazard ratios were calculated in univariate and multivariate survival analyses. Forty-two (47%) were considered positive for p53 expression and 18 (20%) were positive for Bcl-2. Positive expression for p53 was less frequent in patients in FIGO stage I (22%). Positive staining for Bcl-2 correlated significantly with the histologic type (P < 0.01). No direct correlations could be demonstrated between p53 and Bcl-2 expression and age or histologic grade. In univariate analysis, p53 and Bcl-2 expression were not significantly correlated with overall survival, disease-free survival, or progression time. FIGO stage III and IV and residual disease > or =2 cm3 after first surgery were significantly correlated with poor outcome in univariate analysis. FIGO stage retained their independent prognostic value in multivariate analysis. Neither p53 nor Bcl-2 had any significant influence on outcome in multivariate survival analysis. FIGO stage proved to be the only significant independent prognostic factor in epithelial ovarian cancer, although residual disease remains correlated with disease-free survival.
本研究旨在通过多变量分析评估临床和病理变量以及p53和Bcl-2在上皮性卵巢癌中的预后重要性。对90例患者的肿瘤组织进行免疫组织化学分析,以检测p53和Bcl-2的表达。在单变量和多变量生存分析中计算风险比。42例(47%)p53表达呈阳性,18例(20%)Bcl-2呈阳性。p53阳性表达在国际妇产科联盟(FIGO)I期患者中较少见(22%)。Bcl-2阳性染色与组织学类型显著相关(P<0.01)。p53和Bcl-2表达与年龄或组织学分级之间未显示直接相关性。在单变量分析中,p53和Bcl-2表达与总生存期、无病生存期或进展时间均无显著相关性。在单变量分析中,FIGO III期和IV期以及首次手术后残留病灶≥2 cm³与不良预后显著相关。在多变量分析中,FIGO分期保留了其独立的预后价值。在多变量生存分析中,p53和Bcl-2对预后均无显著影响。尽管残留病灶仍与无病生存期相关,但FIGO分期被证明是上皮性卵巢癌唯一显著的独立预后因素。