Hirvikoski P, Kumpulainen E, Virtaniemi J, Johansson R, Haapasalo H, Marin S, Halonen P, Helin H, Raitiola H, Pukander J, Kellokumpu-Lehtinen P, Kosma V M
Department of Pathology, University of Kuopio, Finland.
J Clin Oncol. 1997 Sep;15(9):3111-20. doi: 10.1200/JCO.1997.15.9.3111.
To investigate the prognostic significance of p53 expression and proliferation markers in primary laryngeal squamous cell carcinoma.
Primary tumors for analyses were obtained from 103 patients, with complete follow-up data. All patients were treated between the years 1975 and 1990. The expression of p53 was analyzed with monoclonal D07 antibody and proliferative activity with Ki-67 (MIB-1) and PCNA (monoclonal 19A2) antibodies. Volume corrected mitotic (M/V) index and histological grade were determined in hematoxylin and cosin-stained slides.
Sixty-eight percent of the tumors overexpressed p53. During a median follow-up of 62 months, 41 (40%) of patients relapsed. In univariate analysis site of the primary tumor, stage, p53 expression, histologic grade, and M/V index were significant predictors of disease-free survival. In multivariate analysis, only M/V index was a statistically significant predictor of disease-free survival. Overall survival was significantly better for those overexpressing p53 (10-year cumulative survival rate 68% v 44%, P = .004). In multivariate analysis, M/ V index (P = .02), p53 (P = .02), and stage (P = .007) were statistically significant predictors of overall survival. When this analysis includes stratification according to the type of treatment received, M/V index (P = .007), stage (P = .0002), and p53 (P = .006) were even more significant predictors of overall survival. No association between p53 status and proliferative activity was found.
Overexpression of p53 is associated with favorable disease-free and overall survival in laryngeal squamous cell carcinoma. It may also have an independent prognostic value in laryngeal cancer. M/V index, p53 overexpression, and stage predict with significant accuracy the 10-year overall survival.
探讨p53表达及增殖标志物在原发性喉鳞状细胞癌中的预后意义。
选取103例有完整随访数据的患者的原发性肿瘤进行分析。所有患者均于1975年至1990年间接受治疗。采用单克隆D07抗体分析p53的表达，用Ki-67（MIB-1）和PCNA（单克隆19A2）抗体分析增殖活性。在苏木精和伊红染色的切片上测定体积校正有丝分裂（M/V）指数和组织学分级。
68%的肿瘤p53过表达。在中位随访62个月期间，41例（40%）患者复发。单因素分析显示，原发性肿瘤部位、分期、p53表达、组织学分级及M/V指数是无病生存的显著预测因素。多因素分析显示，只有M/V指数是无病生存的统计学显著预测因素。p53过表达患者的总生存期明显更好（10年累积生存率68%对44%，P = 0.004）。多因素分析显示，M/V指数（P = 0.02）、p53（P = 0.02）和分期（P = 0.007）是总生存期的统计学显著预测因素。当该分析根据接受的治疗类型进行分层时，M/V指数（P = 0.007）、分期（P = 0.0002）和p53（P = 0.006）是总生存期更显著的预测因素。未发现p53状态与增殖活性之间存在关联。
p53过表达与喉鳞状细胞癌良好的无病生存期和总生存期相关。它在喉癌中可能也具有独立的预后价值。M/V指数、p53过表达和分期能显著准确地预测10年总生存期。
