Moch H, Sauter G, Gasser T C, Buchholz N, Bubendorf L, Richter J, Jiang F, Dellas A, Mihatsch M J
Institute of Pathology, University of Basel, Switzerland.
Urol Res. 1997;25 Suppl 1:S25-30. doi: 10.1007/BF00942044.
The clinical course of renal cell carcinoma (RCC) is highly variable. Overexpression of the p53 protein has been suggested as a possible prognostic parameter in RCC. Overexpression of the mdm-2 oncogene product has been shown to interact with the p53 function. To investigate the immunohistochemical overexpression of mdm-2 protein in comparison with that of p53 protein in RCC, 50 nonpapillary pT3 RCCs were immunostained for p53 protein (DO-7) and mdm-2 (IF2). Tumor growth fraction (Ki-67 labeling index; MIB-1) was determined by immunohistochemistry. p53 positivity was detected in 16% of tumors. mdm-2 overexpression was seen in 30% of RCCs. There was a significant association between p53 and mdm-2 immunostaining (P = 0.0006), suggesting that mdm-2 protein may contribute to p53 protein stabilization in RCC. p53 overexpression was associated with a high Ki-67 LI (P = 0.0002), suggesting that p53 overexpression is involved in growth control in RCC. Survival analysis showed that Ki-67 LI (P = 0.04) and p53 overexpression were associated with poor prognosis (P = 0.0021), whereas mdm-2 overexpression was not related to patient outcome (P = 0.73). A Cox regression analysis revealed tumor stage (P < 0.001) and p53 overexpression (P < 0.05) to be independent prognostic parameters. It is concluded that p53 but not mdm-2 may be of practical relevance in predicting patient prognosis in RCC.
肾细胞癌（RCC）的临床病程差异很大。p53蛋白的过表达被认为可能是RCC的一个预后参数。已表明mdm-2癌基因产物的过表达与p53功能相互作用。为了研究RCC中mdm-2蛋白与p53蛋白相比的免疫组化过表达情况，对50例非乳头状pT3期RCC进行了p53蛋白（DO-7）和mdm-2（IF2）免疫染色。通过免疫组化测定肿瘤生长分数（Ki-67标记指数；MIB-1）。16%的肿瘤检测到p53阳性。30%的RCC中可见mdm-2过表达。p53和mdm-2免疫染色之间存在显著相关性（P = 0.0006），表明mdm-2蛋白可能有助于RCC中p53蛋白的稳定。p53过表达与高Ki-67 LI相关（P = 0.0002），表明p53过表达参与RCC的生长控制。生存分析表明，Ki-67 LI（P = 0.04）和p53过表达与预后不良相关（P = 0.0021），而mdm-2过表达与患者预后无关（P = 0.73）。Cox回归分析显示肿瘤分期（P < 0.001）和p53过表达（P < 0.05）是独立的预后参数。结论是，p53而非mdm-2可能在预测RCC患者预后方面具有实际意义。
