Geisler J P, Geisler H E, Wiemann M C, Givens S S, Zhou Z, Miller G A
Department of Obstetrics and Gynecology, St. Vincent Hospital and Health Care Center, Indianapolis, Indiana 46260, USA.
Gynecol Oncol. 1997 Sep;66(3):435-8. doi: 10.1006/gyno.1997.4799.
The perceived function of wild-type p53 is suppression of cell proliferation. An alteration in the p53 tumor suppressor gene is a common defect in human malignancies. The purpose of this study was to prospectively determine whether p53 expression, as quantified by image analysis, was related to traditional prognostic indicators as well as survival in patients epithelial ovarian cancer.
Eighty-three consecutive patients with epithelial ovarian cancer had their p53 expression studied by immunohistochemical staining and quantified by image analysis. Unless otherwise noted, p53 expression was reported as the percentage positive nuclear area staining.
The mean follow-up was 37 months (median, 30 months; range 24-55 months). In patients with serous carcinomas of the ovary, the mean p53 expression was 29.4%, whereas in patients with other histologies, the mean was 10.5% (P < 0.001). The tumors of patients with stage III or IV tumors stained significantly higher (mean 28. 7%) than the tumors of patients with stage I or II disease (mean 8. 36%) (P < 0.001). The tumors of patients with disease which could be optimally cytoreduced stained significantly lower (mean 23.0%) than the tumors of patients whose disease was unable to be optimally cytoreduced (mean 28.6%) (P = 0.041). Utilizing survival as the endpoint for multivariate analysis, FIGO stage (P = 0.006), p53 expression (P = 0.046), and the level of cytoreduction (P < 0.001) were independent prognostic indicators.
Image analysis allows quantitative measurements of p53 staining. p53 staining is significantly higher in advanced-stage, high-grade tumors which are unable to be cytoreduced than in early-stage, low-grade tumors which can be optimally cytoreduced. p53 expression is an independent prognostic indicator of survival in patients with epithelial ovarian carcinomas.
野生型p53的公认功能是抑制细胞增殖。p53肿瘤抑制基因的改变是人类恶性肿瘤中的常见缺陷。本研究的目的是前瞻性地确定通过图像分析量化的p53表达是否与传统预后指标以及上皮性卵巢癌患者的生存率相关。
连续83例上皮性卵巢癌患者通过免疫组织化学染色研究其p53表达，并通过图像分析进行量化。除非另有说明，p53表达报告为阳性核面积染色的百分比。
平均随访37个月（中位数30个月；范围24 - 55个月）。在卵巢浆液性癌患者中，p平均表达为29.4%，而在其他组织学类型的患者中，平均为10.5%（P < 0.001）。III期或IV期肿瘤患者的肿瘤染色显著高于I期或II期疾病患者的肿瘤（平均28.7%）（平均8.36%）（P < 0.001）。疾病能够实现最佳细胞减灭的患者的肿瘤染色显著低于疾病无法实现最佳细胞减灭的患者的肿瘤（平均23.0%）（平均28.6%）（P = 0.041）。以生存作为多变量分析的终点，国际妇产科联盟（FIGO）分期（P = 0.006）、p53表达（P = 0.046）和细胞减灭水平（P < 0.001）是独立的预后指标。
图像分析可对p53染色进行定量测量。在无法进行细胞减灭的晚期、高级别肿瘤中，p53染色显著高于可实现最佳细胞减灭的早期、低级别肿瘤。p53表达是上皮性卵巢癌患者生存的独立预后指标。
