Lundgren Caroline, Auer Gert, Frankendal Bo, Nilsson Bo, Nordström Britta
Department of Gynaecologic Oncology, Radiumhemmet Karolinska University Hospital, Stockholm, Sweden.
Acta Oncol. 2004;43(1):49-56. doi: 10.1080/02841860310018990.
The prognostic impact of DNA ploidy, MIB-1 and p53 was evaluated in relation to clinical and histopathological features in surgical stage I endometrial carcinoma (n = 284) and in the histopathological endometrioid subgroup (n = 257). Tumour material from 284 consecutive patients was analysed regarding image cytometric DNA ploidy and the immunohistochemical MIB-1 and p53 expression. Twenty-four tumours relapsed. In univariate analysis, histopathological subgroup (endometrioid vs. non-endometrioid), grade, DNA ploidy and p53 were highly significant prognostic factors (p < or = 0.001). MIB-1 was also significant (p = 0.039). In the endometrioid subgroup only DNA ploidy and p53 were significant (p < 0.001). In multivariate analysis of the entire material, ploidy and histopathological subgroup retained their significance (p = 0.001, p = 0.004), whereas only ploidy was significant in the endometrioid subgroup (p = 0.001). DNA ploidy was the strongest predictor of relapse-free survival and the only independent prognostic factor in the endometrioid subgroup.
在Ⅰ期手术的子宫内膜癌(n = 284)以及组织病理学子宫内膜样癌亚组(n = 257)中,评估了DNA倍体、MIB-1和p53与临床及组织病理学特征相关的预后影响。对连续284例患者的肿瘤组织进行了图像细胞术DNA倍体分析以及免疫组化MIB-1和p53表达分析。24例肿瘤复发。单因素分析中,组织病理学亚组(子宫内膜样癌与非子宫内膜样癌)、分级、DNA倍体和p53是高度显著的预后因素(p≤0.001)。MIB-1也具有显著性(p = 0.039)。在子宫内膜样癌亚组中,只有DNA倍体和p53具有显著性(p < 0.001)。对全部样本进行多因素分析时,倍体和组织病理学亚组仍具有显著性(p = 0.001,p = 0.004),而在子宫内膜样癌亚组中只有倍体具有显著性(p = 0.001)。DNA倍体是无复发生存最强的预测指标,也是子宫内膜样癌亚组中唯一的独立预后因素。