Geisler J P, Wiemann M C, Zhou Z, Miller G A, Geisler H E
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, St. Vincent Hospital and Health Care Center, Indianapolis, Indiana 46260, USA.
Gynecol Oncol. 1996 May;61(2):245-8. doi: 10.1006/gyno.1996.0133.
One of the most common genetic alterations to occur in human cancers is an alteration of the p53 tumor suppressor gene. Although endometrial cancer is the most common gynecologic malignancy in the United States, any connection between it and p53 is just beginning to be explored.
Forty-six consecutively surgically treated patients with endometrial cancer had their p53 expression studied by immunoperoxidase staining and quantified by image analysis.
Thirty-five patients had endometrioid adenocarcinomas, 3 had adenosquamous carcinomas, 3 had papillary serous carcinomas, 3 had clear cell carcinomas, and 2 had undifferentiated carcinomas. p53 expression ranged from 0.0 to 55.8% with a mean of 10.7% for the cohort. For the patients with endometrioid carcinomas, the mean p53 expression was 3.9%, while for those with more aggressive histologies it was 32.4% (P < 0.001). Sixteen of the 35 endometrioid tumors (45.7%) stained positive for p53, while 11 of the remaining 12 (91.2%) tumors with more aggressive histologies stained positive (P < 0.01). Increasing histologic grade correlated with an increasing p53 expression (P = 0.006). The percentage of patient tumors expressing p53 was found to be higher in FIGO stage II, III, and IV than in FIGO stage I cancer (P = 0.01). However, the mean p53 expression was not different between early (stage 1) and advanced (stage 11, III, and IV) cancers (P = 0.55). Utilizing recurrence as the endpoint for multivariate analysis, FIGO stage and p53 expression were the only independent prognostic indicators found.
p53 expression is more common in more aggressive histologic subtypes than in endometrioid adenocarcinomas. It is an independent prognostic indicator of disease recurrence.
人类癌症中最常见的基因改变之一是p53肿瘤抑制基因的改变。虽然子宫内膜癌是美国最常见的妇科恶性肿瘤，但它与p53之间的任何联系才刚刚开始被探索。
46例接受手术治疗的子宫内膜癌患者通过免疫过氧化物酶染色研究其p53表达，并通过图像分析进行定量。
35例患者为子宫内膜样腺癌，3例为腺鳞癌，3例为乳头状浆液性癌，3例为透明细胞癌，2例为未分化癌。该队列中p53表达范围为0.0%至55.8%，平均为10.7%。对于子宫内膜样癌患者，p53平均表达为3.9%，而对于组织学类型更具侵袭性的患者，其为32.4%（P<0.001）。35例子宫内膜样肿瘤中有16例（45.7%）p53染色阳性，而其余12例中11例（91.2%）组织学类型更具侵袭性的肿瘤染色阳性（P<0.01）。组织学分级增加与p53表达增加相关（P=0.006）。发现国际妇产科联盟（FIGO）II期、III期和IV期患者肿瘤表达p53的百分比高于FIGO I期癌症（P=0.01）。然而，早期（I期）和晚期（II期、III期和IV期）癌症之间的p53平均表达没有差异（P=0.55）。以复发作为多变量分析的终点，发现FIGO分期和p53表达是仅有的独立预后指标。
p53表达在组织学类型更具侵袭性的亚型中比在子宫内膜样腺癌中更常见。它是疾病复发的独立预后指标。
