Bauer J J, Sesterhenn I A, Mostofi K F, McLeod D G, Srivastava S, Moul J W
Urology Service, Departments of Surgery and Clinical Investigation, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
Clin Cancer Res. 1995 Nov;1(11):1295-300.
Immunohistochemical (IHC) staining for p53 protein nuclear expression was evaluated in archival paraffin-embedded radical prostatectomy specimens from 139 patients with clinically localized prostate cancer followed up from 1 to 8 (mean, 4) years. Elevated nuclear p53 protein expression was detected in 85 (61%) of 139 patients, being heterogeneous and focal in the majority of specimens. Only four specimens displayed homogeneous nuclear accumulation of p53 protein. Disease progression, most commonly prostate-specific antigen elevation, was noted in 46 (33%) patients, with 39 (85%) having positive p53 protein IHC stains. Conversely, 93 (67%) of 139 have not recurred, with 46 (49%) having positive p53. Of all 54 p53-negative patients, 47 (87%) have had no disease recurrence. An increased p53 protein IHC stain was associated with a higher pathological stage (T1 and T2, 51% versus >/=T3, 69%) and Gleason score 2-4, 17%; 5-7, 72%; and 8-10, 87.5%). Despite these associations, p53 IHC staining was an independent predictor of disease-free survival in a multivariate analysis of p53, age, race, stage, and grade. This study revealed that a majority of clinically localized prostate cancers heterogeneously express elevated nuclear levels of p53 protein in at least a subset of malignant cells, and that this expression is an independent predictor of disease progression in prostate cancer patients after radical prostatectomy.
在139例临床局限性前列腺癌患者的存档石蜡包埋根治性前列腺切除术标本中，评估了p53蛋白核表达的免疫组织化学（IHC）染色情况，这些患者的随访时间为1至8年（平均4年）。139例患者中有85例（61%）检测到核p53蛋白表达升高，在大多数标本中呈异质性且为局灶性。只有4个标本显示p53蛋白在核内均匀积聚。46例（33%）患者出现疾病进展，最常见的是前列腺特异性抗原升高，其中39例（85%）p53蛋白IHC染色呈阳性。相反，139例中有93例（67%）未复发，其中46例（49%）p53染色呈阳性。在所有54例p53阴性患者中，47例（87%）无疾病复发。p53蛋白IHC染色增加与更高的病理分期相关（T1和T2期，51%；≥T3期，69%）以及Gleason评分（2 - 4分，17%；5 - 7分72%；8 - 10分，87.5%）。尽管存在这些关联，但在对p53、年龄、种族、分期和分级进行多变量分析时，p53 IHC染色是无病生存的独立预测因素。这项研究表明，大多数临床局限性前列腺癌在至少一部分恶性细胞中异质性地表达核水平升高的p53蛋白，并且这种表达是前列腺癌患者根治性前列腺切除术后疾病进展的独立预测因素。
