Tomić Snjezana, Ilić Forko Jadranka, Babić Damir, Sundov Dinka, Kuret Sendi, Andelinović Simun
Department of Pathology, Split University Hospital Center and School of Medicine, Croatia.
Croat Med J. 2003 Aug;44(4):429-34.
To demonstrate immunohistochemical expression of p53, c-erbB-2, and nm23 proteins in ovarian cancer and to establish their correlation with such predictive factors as clinical stage, grade, and vascular invasion. The effect of protein overexpression on patients' overall survival was also assessed.
We performed immunohistochemical analysis of formalin-fixed, paraffin-embedded specimens from 80 ovarian carcinomas, using the anti-nm23, p53, and c-erbB-2 monoclonal antibodies. Immunohistochemical results were scored semiquantitatively. All patients were staged according to the criteria of the International Federation of Gynecology and Obstetrics (FIGO) staging system (I-IV). Carcinomas were graded as low- or high-grade, according to the modified grading system recommended by Shimatzu and Silverberg. For univariate analysis, survival time was analyzed by Kaplan-Meier method, and the log-rank test was used to assess the differences between the groups. For multivariate analysis, Cox proportional hazard regression model was used to examine several parameters simultaneously.
Univariate analysis showed that advanced clinical stage (p<0.001); positive staining for nm23 (p<0.001), p53 (p=0.021), and c-erbB-2 (p=0.003) protein; high histological grade (p<0.001); and vascular invasion (p=0.006) were associated with shorter overall survival. Multivariate analysis revealed only clinical stage as an independent prognostic parameter (p=0.014). Multivariate analysis for early-stage disease showed that only the presence of vascular invasion was significantly associated with shorter survival (p=0.008), whereas none of the parameters analyzed for the advanced-stage disease showed independent predictive value for prognosis.
The overexpression of p53, nm23, and c-erbB-2 proteins was associated with other parameters characteristic of aggressive tumors, such as advanced clinical stage, high grade, and/or presence of vascular invasion. However, this overexpression had no independent prognostic value either for overall survival or survival corrected by clinical stages.
证明p53、c-erbB-2和nm23蛋白在卵巢癌中的免疫组化表达，并确定它们与临床分期、分级和血管侵犯等预测因素的相关性。还评估了蛋白过表达对患者总生存期的影响。
我们使用抗nm23、p53和c-erbB-2单克隆抗体，对80例卵巢癌的福尔马林固定、石蜡包埋标本进行免疫组化分析。免疫组化结果进行半定量评分。所有患者均根据国际妇产科联合会（FIGO）分期系统（I-IV期）进行分期。根据Shimatzu和Silverberg推荐的改良分级系统，将癌分为低级别或高级别。单因素分析时，生存时间采用Kaplan-Meier法分析，对数秩检验用于评估组间差异。多因素分析时，采用Cox比例风险回归模型同时检验多个参数。
单因素分析显示，晚期临床分期（p<0.001）；nm23（p<0.001）、p53（p=0.021）和c-erbB-2（p=0.003）蛋白阳性染色；高组织学分级（p<0.001）；以及血管侵犯（p=0.006）与较短的总生存期相关。多因素分析显示只有临床分期是独立的预后参数（p=0.014）。早期疾病的多因素分析显示，只有血管侵犯的存在与较短的生存期显著相关（p=0.008），而晚期疾病分析的参数均未显示对预后有独立的预测价值。
p53、nm23和c-erbB-2蛋白的过表达与侵袭性肿瘤的其他特征参数相关，如晚期临床分期、高级别和/或血管侵犯的存在。然而，这种过表达对总生存期或经临床分期校正的生存期均无独立的预后价值。
