早期（FIGO I-II）上皮性卵巢癌中同时存在 p53 和 PTEN 对预后的影响。
Prognostic impact of concomitant p53 and PTEN on outcome in early stage (FIGO I-II) epithelial ovarian cancer.
机构信息
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
出版信息
Int J Gynecol Cancer. 2011 Aug;21(6):1024-31. doi: 10.1097/IGC.0b013e31821dc906.
INTRODUCTION
The objective of the study was to evaluate the prognostic effect of p53, PTEN, and concomitant p53 PTEN status on clinicopathologic features, recurrent disease, and disease-free survival (DFS) of 131 patients in FIGO stages I to II with epithelial ovarian cancer.
METHODS
The technique of tissue microarray and immunohistochemistry was used for the detection of positivity of the biologic markers p53 and PTEN.
RESULTS
In the complete series, the 5-year DFS rate was 68%, and the overall survival rate was 71%. Positive staining for p53 and PTEN was detected in 25% and 22% of cases, respectively. Positivity of p53 was associated with tumor grade in the total series but not in the subgroup of serous tumors. In survival analysis, there was worse survival (P = 0.003) in the group of patients with p53-positive tumors compared with the group of patients with p53-negative tumors with DFS of 62% and 82%, respectively. Furthermore, DFS was 15% for the subgroup of patients with concomitant p53-positivity and PTEN-negativity of tumors compared with DFS of 62% for others in 1 group (p53+PTEN+, p53-PTEN+, p53-PTEN-) at 100 months. The difference was highly significant (P = 0.006). FIGO stage (odds ratio = 8.0) and p53 PTEN status (odds ratio = 0.6) were predictive factors for tumor recurrences in a logistic regression and prognostic factors with hazard ratios (HRs) of 4.0 and 0.6, respectively, in a multivariate Cox regression analysis. In a separate Cox regression analysis, FIGO stage (HR = 3.6) and p53 status (HR = 2.0) were prognostic factors for DFS. For serous tumors (n = 51) recurrent disease was associated with FIGO stage (P = 0.013), and p53 loss (P = 0.029) but not with FIGO grade (P = 0.169).
CONCLUSIONS
p53 status divides ovarian carcinomas into 2 subgroups after prognosis, also in serous tumors. Presence of PTEN in p53-positive tumors seems to protect from bad prognosis and absence of PTEN seems to worsen prognosis in early stages.
简介
本研究的目的是评估 131 例FIGO Ⅰ至Ⅱ期上皮性卵巢癌患者的 p53、PTEN 及其同时表达状态对临床病理特征、复发疾病和无病生存（DFS）的预后影响。
方法
采用组织微阵列和免疫组织化学技术检测生物标志物 p53 和 PTEN 的阳性表达。
结果
在完整的研究系列中，5 年 DFS 率为 68%，总生存率为 71%。p53 和 PTEN 的阳性染色率分别为 25%和 22%。p53 阳性在整个研究系列中与肿瘤分级相关，但在浆液性肿瘤亚组中不相关。在生存分析中，与 p53 阴性肿瘤患者相比，p53 阳性肿瘤患者的生存状况较差（P=0.003），DFS 率分别为 62%和 82%。此外，在伴有 p53 阳性和 PTEN 阴性肿瘤的亚组中，DFS 为 15%，而在 1 组中，DFS 为 62%（p53+PTEN+，p53-PTEN+，p53-PTEN-），100 个月时差异具有统计学意义（P=0.006）。FIGO 分期（比值比=8.0）和 p53-PTEN 状态（比值比=0.6）是逻辑回归中肿瘤复发的预测因素，在多变量 Cox 回归分析中，危险比（HR）分别为 4.0 和 0.6。在单独的 Cox 回归分析中，FIGO 分期（HR=3.6）和 p53 状态（HR=2.0）是 DFS 的预后因素。对于浆液性肿瘤（n=51），复发疾病与 FIGO 分期（P=0.013）和 p53 缺失（P=0.029）相关，而与 FIGO 分级无关（P=0.169）。
结论
p53 状态将卵巢癌分为 2 个亚组，也包括浆液性肿瘤。在 p53 阳性肿瘤中存在 PTEN 似乎可以保护免受不良预后，而不存在 PTEN 似乎会使早期阶段的预后恶化。
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