Yamasaki F, Tokunaga O, Sugimori H
Department of Pathology, Saga Medical School, 5-1-1 Nabeshima, Saga, 849, Japan.
Gynecol Oncol. 1997 Sep;66(3):439-48. doi: 10.1006/gyno.1997.4783.
The apoptotic index (apoptotic cells/1000 tumor cells, AI) was evaluated in 71 ovarian carcinomas, all surgically resected. Apoptosis was examined by modified terminal deoxynucleotidyltransferase-mediated deoxyuridine triphosphate-biotin nick end-labeling (TUNEL) method in histologic sections. High AI (>/=2.8) significantly correlated with high mitotic index (P = 0.05), high histologic grade of the tumor (P = 0. 018), and short overall survival (P = 0.017). An inverse relationship between AI and bcl-2 protein expression was also observed (P = 0.007). In addition, AI was assessed in 5 ovarian epithelial tumors of borderline malignancy, and all were categorized as low AI (<2.8). No significant correlation was found between AI and other clinicopathologic factors, such as age, clinical stage, lymph node metastasis, tumor size, histology of the tumor, and expression of p53 protein. Multivariate survival analysis showed that only clinical stage (P = 0.0395) and mitotic index (P = 0.0387) had independent prognostic value, whereas AI did not. Our results suggest that counting apoptosis can be useful for predicting the patient survival in ovarian carcinoma, although AI is not an independent prognostic factor. It is also suggested that bcl-2 protein is an important regulator of apoptosis in ovarian carcinoma.
对71例均经手术切除的卵巢癌进行凋亡指数（凋亡细胞数/1000个肿瘤细胞，AI）评估。采用改良的末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸生物素缺口末端标记法（TUNEL法）在组织学切片上检测凋亡情况。高AI（≥2.8）与高有丝分裂指数显著相关（P = 0.05），与肿瘤的高组织学分级显著相关（P = 0.018），与总生存期短显著相关（P = 0.017）。还观察到AI与bcl-2蛋白表达呈负相关（P = 0.007）。此外，对5例交界性恶性卵巢上皮性肿瘤进行了AI评估，所有病例均归类为低AI（<2.8）。未发现AI与其他临床病理因素之间存在显著相关性，如年龄、临床分期、淋巴结转移、肿瘤大小、肿瘤组织学类型以及p53蛋白表达。多因素生存分析显示，只有临床分期（P = 0.0395）和有丝分裂指数（P = 0.0387）具有独立的预后价值，而AI没有。我们的结果表明，尽管AI不是一个独立的预后因素，但计算凋亡情况对于预测卵巢癌患者的生存可能是有用的。还表明bcl-2蛋白是卵巢癌凋亡的重要调节因子。
