Department of Obstetrics and Gynecology, Chung-Ang University School of Medicine, Seoul, Korea.
Gynecol Oncol. 2010 Mar;116(3):533-8. doi: 10.1016/j.ygyno.2009.11.018. Epub 2009 Dec 14.
The aim of this study was to evaluate the prognostic impact of p53 alteration in human uterine endometrial adenocarcinoma.
One hundred and thirty-one patients with primary endometrial adenocarcinoma were included in the study. The p53 mutation and/or protein expression were evaluated by polymerase chain reaction-single-strand conformational polymorphism and by immunohistochemical analysis, respectively. Clinical and pathological parameters were obtained from medical records. Survival data were estimated using Kaplan-Meier estimates and compared with the log-rank test where indicated. Multivariate analysis was performed using the Cox regression method.
Thirty nine cases (29.8%) containing p53 alterations had a lower disease specific-survival rate and disease-free survival rate than those without p53 alterations. Statistically significant correlations were seen between p53 alteration and non-endometrioid histology type, high grade tumors, and the absence of progesterone receptor. Multivariate analyses showed that both p53 alteration and FIGO stage at diagnosis were adverse prognostic factors. The group of women with p53 alteration had an 11.0-fold increased risk of disease specific death (95% confidence interval: 1.008-120.765) compared to women whose tumors lacked p53 alteration.
p53 alteration defines a subset of endometrial adenocarcinoma with highly aggressive behavior and predicts lower survival in patients with endometrial adenocarcinoma.
本研究旨在评估 p53 改变对人子宫内膜腺癌的预后影响。
本研究纳入了 131 例原发性子宫内膜腺癌患者。通过聚合酶链反应-单链构象多态性和免疫组织化学分析分别评估了 p53 突变和/或蛋白表达。从病历中获得了临床和病理参数。使用 Kaplan-Meier 估计法估计生存数据，并在需要时使用对数秩检验进行比较。使用 Cox 回归方法进行多变量分析。
39 例（29.8%）含有 p53 改变的病例比没有 p53 改变的病例具有更低的疾病特异性生存率和无病生存率。p53 改变与非子宫内膜样组织学类型、高级别肿瘤和孕激素受体缺失之间存在显著的相关性。多变量分析表明，p53 改变和诊断时的 FIGO 分期均为不良预后因素。与肿瘤中缺乏 p53 改变的女性相比，p53 改变的女性疾病特异性死亡的风险增加了 11.0 倍（95%置信区间：1.008-120.765）。
p53 改变定义了具有高度侵袭性行为的子宫内膜腺癌亚组，并预测了子宫内膜腺癌患者的生存率降低。
