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[子宫内膜癌临床病理及特定免疫组化因素的预后意义]

[Prognostic significance of clinic pathological and selected immunohistochemical factors in endometrial cancer].

作者信息

Marková I, Pilka R, Dusková M, Zapletalová J, Kudela M

机构信息

Ustav genetiky a fetální medicíny, FN a LF UP, Olomouc.

出版信息

Ceska Gynekol. 2010 May;75(3):193-9.

Abstract

OBJECTIVE

To assess the immunohistochemical expression of p53, bcl-2, c-erbB-2, Ki-67, estrogen (ER) and progesterone (PR) receptors in endometrial cancer patients. To assess the relation between steroid receptors positivity and other markers. To evaluate the prognostic significance of clinicopathologic and immunohistochemical markers on patient disease free survival.

DESIGN

Experimental prospective study.

SETTING

Department of Obstetrics and Gynaecology, Institute of Human Genetics, Department of Pathology, Department of Biophysics, Palacky University Medical School and University Hospital, Olomouc.

METHODS

We studied 144 cases of primary untreated endometrial carcinoma in which the p53, bcl-2, c-erbB-2, Ki-67, ER and PR antigens were investigated with the use of an immunohistochemical method. In a group of 122 patients we assessed disease free survival (DFS) in relation to clinicopathologic and immunohistochemical factors.

RESULTS

From the total group of 144 patients, 122 were included for survival analysis. We found 15 (12.3%) patients with recurrence of the disease. Mean age was 64,5 (34-88) years. Immunohistologic expression was p53 positive in 29 (23.8%), bcl-2 positive in 87 (71.3%), c-erbB-2 positive in 34 (27.9%), Ki-67 positive in 56 (45.9%), ER positive in 97 (79.5%) and PR positive in 106 (86.9%) of cases. In the survival analysis significantly shorter DFS was present in tumours with poor differentiation (G3), deep myometrial invasion (M2) and positive lymphoinvasion (N).

CONCLUSION

Only poor differentiation (G3) and deep myometrial invasion (M2) are significant independent factors for the length of DFS.

摘要

目的

评估子宫内膜癌患者中p53、bcl-2、c-erbB-2、Ki-67、雌激素(ER)和孕激素(PR)受体的免疫组化表达。评估类固醇受体阳性与其他标志物之间的关系。评估临床病理和免疫组化标志物对患者无病生存期的预后意义。

设计

实验性前瞻性研究。

地点

帕拉茨基大学医学院和奥洛穆茨大学医院人类遗传学研究所妇产科、病理科、生物物理系。

方法

我们研究了144例未经治疗的原发性子宫内膜癌病例,采用免疫组化方法检测p53、bcl-2、c-erbB-2、Ki-67、ER和PR抗原。在122例患者中,我们评估了与临床病理和免疫组化因素相关的无病生存期(DFS)。

结果

在144例患者的总组中,122例纳入生存分析。我们发现15例(12.3%)患者疾病复发。平均年龄为64.5(34-88)岁。免疫组化表达显示,p53阳性29例(23.8%),bcl-2阳性87例(71.3%),c-erbB-2阳性34例(27.9%),Ki-67阳性56例(45.9%),ER阳性97例(79.5%),PR阳性106例(86.9%)。在生存分析中,分化差(G3)、肌层浸润深(M2)和淋巴结转移阳性(N)的肿瘤DFS明显较短。

结论

只有分化差(G3)和肌层浸润深(M2)是DFS长度的重要独立因素。

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