Department of Pathology, Queen Elizabeth II Health Sciences Center, Capital District Health Authority, Halifax, NS, Canada B3H 1V8; Dalhousie University, Halifax, NS, Canada B3H 1V8.
Dalhousie University, Halifax, NS, Canada B3H 1V8; Department of Pathology, Saint John Regional Hospital, Horizon Health Network, Saint John, NB, Canada E2L 4L4.
Hum Pathol. 2014 May;45(5):952-60. doi: 10.1016/j.humpath.2013.12.008. Epub 2014 Jan 8.
Recent evidence has invoked immunohistochemical expression of p63 in Merkel cell carcinoma as an adverse prognostic factor. Conflicting data led us to evaluate this. An Eastern Canadian cohort diagnosed between 1990 and 2012 was studied. Demographic and clinical data were obtained from pathology records and Provincial Cancer Registries. Pathological features were evaluated by the investigators. Merkel cell polyomavirus status was known in a subset of cases. Clinicopathological features were correlated with overall survival. The cohort consisted of 83 patients (mean age, 75.8 ± 11.7 years) with a male/female ratio of 1.24:1. In a mean follow-up period of 175 weeks (±177), 51 patients died (61.4%). Of several parameters examined, 6 showed significant adverse associations with survival on univariate analysis: age (hazard ratio [HR], 1.05 [1.02-1.08]), clinical stage (III/IV versus I/II; HR, 2.24 [1.18-4.27]), tumor size (HR, 1.16 [1.05-1.28]), combined versus pure morphology (HR, 1.82 [1.04-3.18]), minimal tumor-infiltrating lymphocytes (HR, 2.23 [1.04-4.78]), and expression of p63 (positive in 49.4%; HR, 1.93 [1.09-3.43]). In the stage I/II subgroup, p63 expression was associated with a trend toward poor survival. On multivariate analysis, p63 expression was not significantly associated with reduced survival. Our data support existing evidence that p63 expression in Merkel cell carcinoma carries adverse implications for survival. That it was not an independent prognostic factor may be due to study size and/or its potential as a confounding variable with clinical stage. Of clinical importance is its association with a trend toward a poor outcome in early stage disease.
最近的证据表明，Merkel 细胞癌中 p63 的免疫组织化学表达是一个不良的预后因素。我们的数据存在冲突，因此对此进行了评估。本研究纳入了 1990 年至 2012 年间在加拿大东部诊断的患者队列。通过病理记录和省级癌症登记处获得了人口统计学和临床数据。研究者评估了病理特征。Merkel 细胞多瘤病毒的状态在部分病例中是已知的。临床病理特征与总生存相关。该队列由 83 名患者组成（平均年龄 75.8 ± 11.7 岁，男/女比例为 1.24:1）。在平均 175 周（±177）的随访期间，有 51 名患者死亡（61.4%）。在对多个参数进行检查后，有 6 个参数在单因素分析中显示出与生存显著不良的关联：年龄（风险比[HR]，1.05[1.02-1.08]）、临床分期（III/IV 期与 I/II 期；HR，2.24[1.18-4.27]）、肿瘤大小（HR，1.16[1.05-1.28]）、合并与单纯形态（HR，1.82[1.04-3.18]）、肿瘤浸润淋巴细胞最少（HR，2.23[1.04-4.78]）和 p63 表达（阳性 49.4%；HR，1.93[1.09-3.43]）。在 I/II 期亚组中，p63 表达与生存趋势不良相关。在多因素分析中，p63 表达与生存率降低无显著相关性。我们的数据支持现有的证据，即 Merkel 细胞癌中 p63 的表达对生存有不良影响。p63 表达不是一个独立的预后因素，可能是由于研究规模和/或其作为临床分期混杂变量的潜在可能性。p63 表达与早期疾病预后不良趋势相关，这在临床上很重要。
