The Cancer Foundation for Minority and Underserved Populations, Chicago, IL, USA.
Ann Surg Oncol. 2010 May;17(5):1398-405. doi: 10.1245/s10434-009-0889-3. Epub 2010 Jan 5.
p53 overexpression has been identified as a poor prognostic marker in breast cancer. We investigate the value of p53 status within the context of stage and intrinsic subtype classification (subtype), in a group of African-American (AA) women of lower socioeconomic status (SES) with primary breast cancer.
Participants were 331 consecutive AA women treated at an urban hospital (median follow-up 41 months) with known subtype [luminal A = estrogen receptor (ER)+ and/or progesterone receptor (PR)+, human epidermal growth factor receptor 2 (HER2)-; luminal B = ER+ and/or PR+, HER2+; HER2+ = ER-, PR-, HER2+; basal = ER-, PR-, HER2-, cytokeratin (CK)5/6+, and/or HER1+; and unclassified = negative for all five markers] and p53 (Pab1801 antibody) immunohistochemical status. Proportional hazards regression models were used to select and evaluate factors prognostic for all-cause mortality.
p53+ status was associated with grade 3 tumors, ER/PR- status, and basal subtype. On univariate analysis, factors related to survival were stage, grade [(3/1) hazard ratio (HR) = 2.64; 95% confidence interval (CI), 1.15-6.07], subtype [(ex. basal/luminal A) HR = 2.15; 95% CI, 1.34-3.45], and p53 status [(+/-) HR = 1.77; 95% CI, 1.15-2.72]. Multivariable modeling indicated that p53+ status remained a negative prognostic factor (HR = 1.63; 95% CI, 1.01-2.59) after adjustment for effects of age, stage, grade, and subtype; 5-year adjusted survival was significantly greater for p53- (66.7%) than p53+ cases (54.7%).
p53 status is an independent predictor of survival after consideration of other strong prognostic factors such as stage, tumor grade, and subtype, and thus may be useful in identifying AA women at high risk of breast cancer mortality.
p53 过表达已被确定为乳腺癌的不良预后标志物。我们研究了 p53 状态在分期和内在亚型分类（亚型）背景下的价值，该研究纳入了一组具有初级乳腺癌的社会经济地位较低的非裔美国（AA）女性。
参与者为在城市医院接受治疗的 331 例连续 AA 女性（中位随访时间为 41 个月），已知亚型[管腔 A = 雌激素受体（ER）+和/或孕激素受体（PR）+，人表皮生长因子受体 2（HER2）-；管腔 B = ER+和/或 PR+，HER2+；HER2+ = ER-，PR-，HER2+；基底 = ER-，PR-，HER2-，细胞角蛋白（CK）5/6+和/或 HER1+；未分类 = 所有五个标志物均为阴性]和 p53（Pab1801 抗体）免疫组织化学状态。使用比例风险回归模型选择和评估与全因死亡率相关的预后因素。
p53+状态与 3 级肿瘤、ER/PR-状态和基底亚型相关。单因素分析表明，与生存相关的因素包括分期、分级[（3/1）风险比（HR）=2.64；95%置信区间（CI），1.15-6.07]、亚型[例如基底/管腔 A（HR）=2.15；95%CI，1.34-3.45]和 p53 状态[（+/-）HR=1.77；95%CI，1.15-2.72]。多变量模型表明，在调整年龄、分期、分级和亚型的影响后，p53+状态仍然是一个负预后因素（HR=1.63；95%CI，1.01-2.59）；5 年调整后的生存率 p53-（66.7%）显著高于 p53+（54.7%）。
在考虑其他强预后因素（如分期、肿瘤分级和亚型）后，p53 状态是生存的独立预测因子，因此可能有助于识别 AA 女性中具有高乳腺癌死亡率风险的患者。
