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p53 基因产物免疫组化表达在可手术乳腺癌中的预后意义。

Prognostic significance of immunohistochemical expression of p53 gene product in operable breast cancer.

机构信息

Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.

出版信息

Cancer Res Treat. 2006 Dec;38(4):218-23. doi: 10.4143/crt.2006.38.4.218. Epub 2006 Dec 31.

Abstract

PURPOSE

The aim of this study was to investigate the prognostic significance of the expression of p53 gene product in operable invasive breast cancer by performing immunohistochemical analysis.

MATERIALS AND METHODS

Between January 1993 and December 2001, 440 operable invasive breast cancer patients underwent immunohistochemical staining for p53, and we retrospectively analyzed these results together with the clinical outcomes.

RESULTS

The overexpression of p53 was detected in 51.6% of the cases. The overexpression of p53 was inversely correlated with lymph node metastasis (p=0.005). The tumor size, tumor histology, histologic grade, hormonal receptor status and tumor stage were not related to the overexpression of p53. Multivariate Cox regression analysis indicate that lymph node metastasis, tumor size and the p53 expression were the significant prognostic factors for overall survival; lymph node metastasis, the estrogen receptor status and the p53 expression were the significant prognostic factors for relapse free survival. On the subgroup analysis, the p53 non-expressors showed better 7-year overall survival (92.7% vs. 76.7%, respectively, p=0.011) and relapse free survival (74.9% vs. 57.8%, respectively, p=0.032) than did the p53 overexpressors for the patients with lymph node metastasis. However, for the patients without lymph node metastasis, the survival rates were not different for both the p53 non-expressors and the p53 overexpressors.

CONCLUSION

Immunohistochemical staining of the p53 gene product was an independent prognostic factor for predicting survival of the lymph node positive invasive breast cancer patients.

摘要

目的

本研究旨在通过免疫组织化学分析,探讨 p53 基因产物在可手术浸润性乳腺癌中的表达与预后的关系。

材料与方法

1993 年 1 月至 2001 年 12 月,对 440 例可手术浸润性乳腺癌患者进行了 p53 免疫组织化学染色,我们回顾性分析了这些结果,并结合临床结果进行了分析。

结果

51.6%的病例中检测到 p53 的过度表达。p53 的过度表达与淋巴结转移呈负相关(p=0.005)。肿瘤大小、肿瘤组织学、组织学分级、激素受体状态和肿瘤分期与 p53 的过度表达无关。多因素 Cox 回归分析表明,淋巴结转移、肿瘤大小和 p53 表达是总生存的显著预后因素;淋巴结转移、雌激素受体状态和 p53 表达是无复发生存的显著预后因素。在亚组分析中,p53 非表达者的 7 年总生存率(92.7%比 76.7%,p=0.011)和无复发生存率(74.9%比 57.8%,p=0.032)均优于淋巴结转移的 p53 过表达者。然而,对于无淋巴结转移的患者,p53 非表达者和 p53 过表达者的生存率无差异。

结论

p53 基因产物的免疫组织化学染色是预测淋巴结阳性浸润性乳腺癌患者生存的独立预后因素。

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