Stattin P, Damber J E, Modig H, Bergh A
Department of Urology and Andrology, Umeå University, Sweden.
Int J Radiat Oncol Biol Phys. 1996 Jul 15;35(5):885-9. doi: 10.1016/0360-3016(96)00134-4.
To test, in a clinical context, the hypothesis that p53 aberrations, assessed by immunoreactivity, are related to radioresistance as suggested by several experimental studies.
Sixty patients with prostate cancer who underwent transurethral resection of the prostate or biopsy prior to definitive external beam therapy were retrospectively identified. The endpoint in the study was cancer specific survival. The nuclear accumulation of the aberrant p53 protein was evaluated by immunohisto-chemistry with the pantropic, monoclonal Ab-6 anti-p53 antibody (clone DO-1) on pretreatment biopsies. Immunoreactivity was related to stage, grade, and cancer-specific survival.
There was a correlation between p53 immunoreactivity and low tumor stage (p < 0.001), but no relation between p53 status and grade was found. Moreover, no significant difference was found in cancer-specific survival between the p53 positive tumors (109 months) and the p53 negative tumors (99 months).
No disadvantage regarding survival was seen for patients with p53 immunoreactive tumors, implicating that p53 immunoreactivity does not infer radioresistance in prostate cancer. This suggests that the p53 inactivation may be a less important determinant of tumor response to radiotherapy in some human cancers than in the previously studied experimental situations. Thus, other mechanisms may be more important in determining outcome after radiation. However, the series is small and data should be interpreted with caution.
在临床环境中检验如下假设，即通过免疫反应性评估的p53畸变与多项实验研究表明的放射抗性相关。
回顾性确定60例在接受确定性外照射治疗前接受经尿道前列腺切除术或活检的前列腺癌患者。研究的终点是癌症特异性生存。通过免疫组织化学方法，使用泛特异性单克隆Ab - 6抗p53抗体（克隆DO - 1）对治疗前活检标本评估异常p53蛋白的核积聚情况。免疫反应性与分期、分级及癌症特异性生存相关。
p53免疫反应性与低肿瘤分期之间存在相关性（p < 0.001），但未发现p53状态与分级之间存在关联。此外，p53阳性肿瘤（109个月）和p53阴性肿瘤（99个月）在癌症特异性生存方面未发现显著差异。
p53免疫反应性肿瘤患者在生存方面未显示出劣势，这意味着p53免疫反应性在前列腺癌中并不意味着放射抗性。这表明在某些人类癌症中，p53失活可能不像在先前研究的实验情况中那样是肿瘤对放疗反应的重要决定因素。因此，其他机制在决定放疗后结果方面可能更重要。然而，该系列病例数量较少，数据解释应谨慎。
