Klemi P J, Pylkkänen L, Kiilholma P, Kurvinen K, Joensuu H
Department of Pathology, University Central Hospital of Turku, Finland.
Cancer. 1995 Oct 1;76(7):1201-8. doi: 10.1002/1097-0142(19951001)76:7<1201::aid-cncr2820760716>3.0.co;2-l.
The clinical significance of p53 suppressor gene nucleoprotein immunostaining in ovarian epithelial cancer has not been determined.
p53 protein expression was studied by immunohistochemistry from paraffin embedded tissue in a series of 136 patients with malignant ovarian epithelial tumors. The median follow-up time of the patients still alive was 10 years.
Sixty (44%) carcinomas stained clearly positive for p53 protein. Positive staining for p53 protein was associated with the serous histologic type (P = 0.0006), a higher than the median S-phase fraction size determined by DNA flow cytometry (P = 0.02), and poor histologic grade of differentiation (P = 0.04), but not with the International Federation of Gynecology and Obstetrics (FIGO) stage, age at diagnosis, or DNA ploidy. Cancers with positive staining had only 17% 5-year and 9% 15-year survival rates compared with 42% 5-year and 36% 15-year survival rates corrected for intercurrent deaths among the rest of patients (P = 0.002). In a multivariate analysis, positive p53 staining was associated with poor survival (relative risk of death, 1.8, 95% confidence interval [CI], 1.2-2.9) together with less than radical surgery (nonradical vs. radical: RR, 5.5; 95% CI, 2.2-13.6), and advanced FIGO stage (RR, 1.4; 95% CI, 1.0-2.0).
Although p53 protein immunostaining is associated with several other prognostic factors in epithelial ovarian cancer, it may also have independent prognostic value in this disease.
p53抑癌基因核蛋白免疫染色在卵巢上皮癌中的临床意义尚未明确。
采用免疫组织化学方法对136例恶性卵巢上皮性肿瘤患者石蜡包埋组织中的p53蛋白表达进行研究。存活患者的中位随访时间为10年。
60例（44%）癌组织p53蛋白染色呈明显阳性。p53蛋白阳性染色与浆液性组织学类型相关（P = 0.0006），与通过DNA流式细胞术测定的高于中位S期分数大小相关（P = 0.02），与组织学低分化相关（P = 0.04），但与国际妇产科联盟（FIGO）分期、诊断时年龄或DNA倍体无关。p53染色阳性的癌症患者5年生存率仅为17%，15年生存率为9%，而其余患者经校正并发死亡后的5年生存率为42%，15年生存率为36%（P = 0.002）。多因素分析显示，p53染色阳性与生存率低相关（死亡相对风险为1.8，95%置信区间[CI]为1.2 - 2.9），同时与未行根治性手术相关（非根治性手术与根治性手术：RR为5.5；95%CI为2.2 - 13.6），以及FIGO晚期相关（RR为1.4；95%CI为1.0 - 2.0）。
虽然p53蛋白免疫染色与上皮性卵巢癌的其他几个预后因素相关，但它在该疾病中可能也具有独立的预后价值。
