Pietiläinen T, Lipponen P, Aaltomaa S, Eskelinen M, Kosma V M, Syrjänen K
Department of Pathology, University of Kuopio, Finland.
J Pathol. 1995 Nov;177(3):225-32. doi: 10.1002/path.1711770303.
A series of 392 female breast carcinomas was analysed immunohistochemically for expression of p53 protein with special emphasis on the role of p53 as an independent prognostic factor. Altogether, 54.8 per cent of the carcinomas expressed p53 protein, with the mean [standard error (SE)] fraction of positive nuclei being 17.1 per cent (1.2 per cent). Expression of p53 protein was independent of tumour metastasis at diagnosis, axillary lymph node status, tumour diameter, histological type, tubule formation, proportion of intraductal growth, margin formation, necrosis, DNA ploidy, and S-phase fraction. A high fraction of p53-positive nuclei was significantly related to patient age under 70 years, high grade, severe nuclear pleomorphism, dense infiltration of tumour by lymphocytes, high mitotic index, and high apoptotic index (for all, P < 0.05). Impaired survival probability in the entire cohort (P = 0.05) and in the axillary lymph node-positive (ANP) tumours (P = 0.015) was associated with a fraction of p53-positive nuclei less than 25 per cent, while in the axillary lymph node-negative (ANN) tumours, expression of p53 had no prognostic value. In multivariate analysis, independent prognostic predictors included axillary lymph node status, tumour diameter, and mitotic index. In the ANN tumours, tumour diameter, fraction of p53-positive nuclei, and tumour grade were independent prognostic factors, whereas in the ANP tumours, diameter and mitotic index were the two independent prognostic factors. The results suggest that abnormal expression of p53 protein is only a weak independent prognostic factor in female breast cancer.
对392例女性乳腺癌进行免疫组织化学分析，以检测p53蛋白的表达情况，并特别强调p53作为独立预后因素的作用。总体而言，54.8%的癌组织表达p53蛋白，阳性细胞核的平均[标准误(SE)]比例为17.1%(1.2%)。p53蛋白的表达与诊断时的肿瘤转移、腋窝淋巴结状态、肿瘤直径、组织学类型、小管形成、导管内生长比例、切缘形成、坏死、DNA倍体和S期比例无关。p53阳性细胞核的高比例与70岁以下患者年龄、高级别、严重核多形性、肿瘤淋巴细胞密集浸润、高有丝分裂指数和高凋亡指数显著相关(所有P<0.05)。整个队列(P=0.05)和腋窝淋巴结阳性(ANP)肿瘤(P=0.015)的生存概率受损与p53阳性细胞核比例低于25%有关，而在腋窝淋巴结阴性(ANN)肿瘤中，p53的表达没有预后价值。多因素分析显示，独立的预后预测因素包括腋窝淋巴结状态、肿瘤直径和有丝分裂指数。在ANN肿瘤中，肿瘤直径、p53阳性细胞核比例和肿瘤分级是独立的预后因素，而在ANP肿瘤中，直径和有丝分裂指数是两个独立的预后因素。结果表明，p53蛋白的异常表达在女性乳腺癌中仅是一个较弱的独立预后因素。
