Juvan Robert, Hudler Petra, Gazvoda Barbara, Repse Stanislav, Bracko Matej, Komel Radovan
Clinical Department for Abdominal Surgery, University Clinical Center, Ljubljana, Slovenia.
Croat Med J. 2007 Apr;48(2):207-17.
To analyze genetic alterations of p53 gene in Slovenian gastric cancer patients and to compare these alterations with clinicopathological parameters in order to assess the value of p53 as a prognostic factor.
We analyzed the samples from 230 Slovenian patients with gastric cancer, collected between 1983 and 2001. p53 expression was evaluated immunohistochemically with DO-7 monoclonal antibody. In addition, loss of heterozigosity (LOH) and microsatellite instability (MSI) of p53 gene were evaluated, as well as its mutational status in the selected population of patients.
p53 expression was associated with poorer survival and it was an independent predictor in multivariate analysis, along with TNM (T--size of tumor, N--nodal involvement, M--distant metastasis) stage status. Loss of heterozigosity and microsatellite instability status did not influence survival, however we found association of loss of heterozigosity with Lauren's (Mantel-Haenszel test, P=0.004) and Ming's (Mantel-Haenszel test, P<0.001) classification, whereas microsatellite instability was associated with gender (Mantel-Haenszel test, P=0.017), TNM stage (chi(2) test, P=0.006) of gastric cancer, and lymph node involvement (pN) (chi(2) test, P=0.004). Conclusions. The data on p53 abnormalities, when considered separately, could be of relative value for predicting the behavior of gastric tumors. However, our analyses showed that studying p53 overexpression, loss of heterozigosity, microsatellite instability, and mutational analysis could provide data that, particularly in combination with some clinicopathological features, might be of clinical value for predicting the tumor behavior and patient response to therapy.
分析斯洛文尼亚胃癌患者中p53基因的遗传改变,并将这些改变与临床病理参数进行比较,以评估p53作为预后因素的价值。
我们分析了1983年至2001年间收集的230例斯洛文尼亚胃癌患者的样本。用DO-7单克隆抗体通过免疫组织化学方法评估p53表达。此外,还评估了p53基因的杂合性缺失(LOH)和微卫星不稳定性(MSI),以及所选患者群体中的突变状态。
p53表达与较差的生存率相关,并且在多变量分析中是一个独立的预测因素,与TNM(T-肿瘤大小,N-淋巴结受累,M-远处转移)分期状态一起。杂合性缺失和微卫星不稳定性状态不影响生存率,然而我们发现杂合性缺失与劳伦(Mantel-Haenszel检验,P = 0.004)和明(Mantel-Haenszel检验,P < 0.001)分类相关,而微卫星不稳定性与性别(Mantel-Haenszel检验,P = 0.017)、胃癌的TNM分期(卡方检验,P = 0.006)和淋巴结受累(pN)(卡方检验,P = 0.004)相关。结论。单独考虑时,p53异常的数据对于预测胃肿瘤的行为可能具有相对价值。然而,我们的分析表明,研究p53过表达、杂合性缺失、微卫星不稳定性和突变分析可以提供数据,特别是与一些临床病理特征相结合时,可能对预测肿瘤行为和患者对治疗的反应具有临床价值。