Liu Joyce F, Hirsch Michelle S, Lee Hang, Matulonis Ursula A
Department of Medical Oncology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA.
Gynecol Oncol. 2009 Dec;115(3):401-6. doi: 10.1016/j.ygyno.2009.08.023. Epub 2009 Sep 30.
Prior studies have suggested that patients diagnosed with ovarian cancer at an older age have worse outcomes. However, few studies have examined whether differing patterns of protein expression in tumors in older patients correlate with this poorer prognosis. We investigated the correlation of age with prognosis and the significance of hormone receptor status in younger versus older patients through construction of a clinically-annotated high-density tissue microarray (HTMA) composed of stage III and IV papillary serous ovarian cancer cases.
Two cohorts of patients (age > or =65 and < or =55 at diagnosis) were identified retrospectively from ovarian carcinoma pathology cases reviewed at our institution between 1999 and 2005. An HTMA was constructed from 148 eligible cases, and clinical data were abstracted through chart and database review.
No difference in survival was observed between younger and older patients. Patients > or =70 years had decreased survival on univariate, but not multivariate, analysis. ER was significantly more likely (p=0.01) and PR significantly less likely (p=0.02) to be expressed in older patients. Neither ER nor PR independently correlated with survival in the overall study population.
Patients with advanced-stage papillary serous ovarian cancer > or =65 years of age at diagnosis have a similar survival as patients < or =55 years. Hormone receptor status differs significantly between the two age groups, and in the younger patient cohort, there is a trend towards longer overall survival for ER/PR positive tumors. These results suggest that ovarian cancer in younger patients differs biologically from that in older patients.
既往研究表明，老年卵巢癌患者的预后较差。然而，很少有研究探讨老年患者肿瘤中不同的蛋白质表达模式是否与这种较差的预后相关。我们通过构建一个由III期和IV期乳头状浆液性卵巢癌病例组成的临床注释高密度组织微阵列（HTMA），研究年龄与预后的相关性以及年轻与老年患者激素受体状态的意义。
回顾性分析1999年至2005年间在我们机构复查的卵巢癌病理病例，确定两组患者（诊断时年龄≥65岁和≤55岁）。从148例符合条件的病例中构建HTMA，并通过图表和数据库回顾提取临床数据。
年轻和老年患者的生存率无差异。单因素分析显示，年龄≥70岁的患者生存率降低，但多因素分析未显示。雌激素受体（ER）在老年患者中表达的可能性显著更高（p = 0.01），孕激素受体（PR）表达的可能性显著更低（p = 0.02）。在整个研究人群中，ER和PR均与生存率无独立相关性。
诊断时年龄≥65岁的晚期乳头状浆液性卵巢癌患者与年龄≤55岁的患者生存率相似。两个年龄组的激素受体状态存在显著差异，在年轻患者队列中，ER/PR阳性肿瘤的总生存期有延长趋势。这些结果表明，年轻患者的卵巢癌在生物学上与老年患者不同。
