Lin Jie, Du Juan, Zhang Chun-yu, Xie Qiao-ting, Zhang Bo, Liu Cong-rong
Department of Pathology, Peking University Health Science Center, Beijing 100191, China.
Zhonghua Bing Li Xue Za Zhi. 2010 Oct;39(10):655-60.
To evaluate the two-tier MDACC grading system for ovarian serous carcinoma by comparing with the WHO grading system, and to investigate the role of p53 immunostaining in ovarian serous carcinoma grading.
72 cases ovarian serous carcinoma of ovary were graded basing on the MDACC and WHO grading systems, respectively. Statistic analyses were made for the relationship between the data obtained from two grading systems and their clinical significance. All the cases were examined immunohistochemically by using antibody against p53 protein and the immunohistochemistry findings were analyzed with the two grading systems and clinical parameters.
There was a good correlation between the MDACC and WHO grading system (r=0.543, P=0.000). Neither system has a definite relationship with the disease-free survival time (P=0.170 vs. P=0.075), cytoreduction (P=0.478 vs. P=0.120), and the curative effect of platinum-based chemotherapy (P=0.418 vs. P=0.403). However, compared with the WHO grading system, MDACC grading system has a better correlation with tumor stage (P=0.041 vs. P=0.002), 3-year disease-free survival rate (P=0.077 vs. P=0.004), overall survival time (P=0.080 vs. P=0.046), and p53 immunohistochemistry results (P=0.334 vs. P=0.035). No significant difference was found between p53 immunohistochemistry results with other clinical characteristics and prognostic factors.
Compared with the WHO system, the MDACC system showed a better prognostic value and was more likely correlated with the novel dualistic model for ovarian serous carcinogenesis. Although p53 immunostaining was valuable in assisting MDACC grading, it should be cautious to use it alone as an independent indicator in predicting the prognosis of ovarian serous carcinoma.
通过与世界卫生组织(WHO)分级系统比较,评估卵巢浆液性癌的两级MDACC分级系统,并探讨p53免疫染色在卵巢浆液性癌分级中的作用。
分别根据MDACC和WHO分级系统对72例卵巢浆液性癌进行分级。对两种分级系统获得的数据之间的关系及其临床意义进行统计分析。所有病例均采用抗p53蛋白抗体进行免疫组织化学检查,并将免疫组织化学结果与两种分级系统及临床参数进行分析。
MDACC和WHO分级系统之间存在良好的相关性(r = 0.543,P = 0.000)。两种系统与无病生存时间(P = 0.170对P = 0.075)、肿瘤细胞减灭术(P = 0.478对P = 0.120)以及铂类化疗疗效(P = 0.418对P = 0.403)均无明确关系。然而,与WHO分级系统相比,MDACC分级系统与肿瘤分期(P = 0.041对P = 0.002)、3年无病生存率(P = 0.077对P = 0.004)、总生存时间(P = 0.080对P = 0.046)以及p53免疫组织化学结果(P = 0.334对P = 0.035)具有更好的相关性。p53免疫组织化学结果与其他临床特征和预后因素之间未发现显著差异。
与WHO系统相比,MDACC系统显示出更好的预后价值,并且更可能与卵巢浆液性癌发生的新型二元模型相关。尽管p53免疫染色在辅助MDACC分级方面有价值,但单独将其作为预测卵巢浆液性癌预后的独立指标时应谨慎使用。