Lu X, Toki T, Konishi I, Nikaido T, Fujii S
Department of Obstetrics and Gynecology, Shinshu University School of Medicine, Matsumoto, Japan.
Cancer. 1998 Jun 15;82(12):2409-17.
The purpose of this study was to assess the prognostic significance of the expression of estrogen receptor and cell cycle regulatory gene products in cervical adenocarcinoma.
In 40 cases of adenocarcinoma of the uterine cervix and 10 normal cervices, expression of estrogen receptor and cell cycle regulatory gene products (cyclin E, p16, p21WAF1/CIP1, p27, p53, and Ki-67) was studied using immunohistochemical techniques. The survival of the patients was analyzed in terms of such variables as the expression of these molecules in the tumor and conventional clinicopathologic features, and the Cox proportional hazards model was used to predict the survival of patients with cervical adenocarcinoma.
Expression of estrogen receptor was consistently observed in normal cervical glands, but in cervical adenocarcinoma it was lost (in 28 cases) or significantly diminished (in 12 cases). Normal cervical glandular cells were usually negative for the cell cycle regulatory gene products, whereas 47.5-85% of cervical adenocarcinomas were positive for these molecules. When the expression of these molecules was analyzed, significant positive correlations were found between p16 and p27, cyclin E and p27, and cyclin E and p21WAF1/CIP1. Univariate survival analysis revealed that the presence of parametrial invasion, the presence of lymph node metastasis, negative staining for p21WAF1/CIP1, and a moderately or poorly differentiated tumor all correlated significantly with a poor prognosis. In a stepwise regression analysis, the expression of p21WAF1/CIP1 and negative pelvic lymph nodes were the best predictors of a favorable prognosis.
Expression of p21WAF1/CIP1 correlated with a favorable prognosis for patients with cervical adenocarcinoma and may serve as a useful marker of survival in cases of this disease.
本研究旨在评估雌激素受体和细胞周期调节基因产物表达在宫颈腺癌中的预后意义。
采用免疫组织化学技术研究40例宫颈腺癌及10例正常宫颈组织中雌激素受体和细胞周期调节基因产物（细胞周期蛋白E、p16、p21WAF1/CIP1、p27、p53和Ki-67）的表达。根据肿瘤中这些分子的表达及传统临床病理特征等变量分析患者的生存率，并采用Cox比例风险模型预测宫颈腺癌患者的生存率。
雌激素受体表达在正常宫颈腺上皮中持续存在，但在宫颈腺癌中缺失（28例）或显著减少（12例）。正常宫颈腺上皮细胞通常对细胞周期调节基因产物呈阴性，而47.5% - 85%的宫颈腺癌对此类分子呈阳性。分析这些分子的表达时，发现p16与p27、细胞周期蛋白E与p27以及细胞周期蛋白E与p21WAF1/CIP1之间存在显著正相关。单因素生存分析显示，宫旁浸润、淋巴结转移、p21WAF1/CIP1阴性染色以及肿瘤中分化或低分化均与预后不良显著相关。在逐步回归分析中，p21WAF1/CIP1的表达及盆腔淋巴结阴性是预后良好的最佳预测指标。
p21WAF1/CIP1的表达与宫颈腺癌患者的良好预后相关，可能是该疾病患者生存的有用标志物。
