Department of Surgery and Molecular Oncology, Dundee University, Ninewells Hospital and Medical School, UK.
Br J Cancer. 2010 Feb 16;102(4):719-26. doi: 10.1038/sj.bjc.6605540. Epub 2010 Jan 26.
The deprivation gap for breast cancer survival remains unexplained by stage at presentation, treatment, or co-morbidities. We hypothesised that p53 mutation might contribute to the impaired outcome observed in patients from deprived communities.
p53 mutation status was determined using the Roche Amplichip research test in 246 women with primary breast cancer attending a single cancer centre and related to deprivation, pathology, overall, and disease-free survival.
p53 mutation, identified in 64/246 (26%) of cancers, was most common in 10 out of 17 (58.8%) of the lowest (10th) deprivation decile. Those patients with p53 mutation in the 10th decile had a significantly worse disease-free survival of only 20% at 5 years (Kaplan-Meier logrank chi(2)=6.050, P=0.014) and worse overall survival of 24% at 5 years (Kaplan-Meier logrank chi(2)=6.791, P=0.009) than women of deciles 1-9 with p53 mutation (c.f. 56% and 72%, respectively) or patients in the 10th decile with wild-type p53 (no disease relapse or deaths).
p53 mutation in breast cancer is associated with socio-economic deprivation and may provide a molecular basis, with therapeutic implications, for the poorer outcome in women from deprived communities.
乳腺癌生存的剥夺差距仍然无法用发病时的分期、治疗或合并症来解释。我们假设 p53 突变可能导致来自贫困社区的患者预后不良。
使用罗氏 Amplichip 研究检测 246 例原发性乳腺癌患者的 p53 突变状态，并与贫困程度、病理学、总生存和无病生存相关。
246 例癌症中有 64 例（26%）发生了 p53 突变，在 17 个（58.8%）最低（第 10）贫困百分位数中有 10 个中最常见。第 10 百分位数中 p53 突变的患者无病生存明显较差，5 年时仅为 20%（Kaplan-Meier 对数秩检验 chi(2)=6.050，P=0.014），总生存更差，5 年时为 24%（Kaplan-Meier 对数秩检验 chi(2)=6.791，P=0.009），而第 1-9 百分位数中 p53 突变的患者（分别为 56%和 72%）或第 10 百分位数中 p53 野生型的患者（无疾病复发或死亡）。
乳腺癌中的 p53 突变与社会经济贫困有关，可能为来自贫困社区的女性预后不良提供分子基础，并具有治疗意义。
