Comparative study of tumor angiogenesis and immunohistochemistry for p53, c-ErbB2, c-myc and EGFr as prognostic factors in gastric cancer
Comparative study of tumor angiogenesis and immunohistochemistry for p53, c-ErbB2, c-myc and EGFr as prognostic factors in gastric cancer
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DOI：
10.14670/hh-15.455
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发表时间：
2000-04-01
影响因子：
2
通讯作者：
Merino, MJ
中科院分区：
文献类型：
--
作者：
Sanz-Ortega, J;Steinberg, SM;Merino, MJ
胃癌（GC）仍然是一种高度侵袭性的恶性肿瘤，预后差，生存率低。GC患者的存活率主要取决于疾病的阶段，早期GC的5年存活率为90-100%，晚期肿瘤的5年存活率为15- 25%。其他预后因素在这些肿瘤中的作用仍在研究中。应用免疫组织化学方法检测了28例胃异型增生、45例早期胃癌和98例进展期胃癌石蜡包埋标本中癌基因p53、c-ErbB 2、c-myc和EGFr的表达。对34例胃癌进行了CD_（34）染色切片微血管密度（MVD）测定。与分期、组织学类型、分化程度、部位、大小、倍体类型和总生存率进行统计学相关性分析。采用Mantel-Cox检验评估哪些因素具有独立的预后价值，肿瘤血管生成和p53蛋白表达与胃癌患者的总生存率有统计学相关性（95%可信区间）。p53蛋白的表达与肿瘤的部位、淋巴结转移及临床分期有关。c-ErbB 2可识别一组预后较差的高分化腺癌。c-myc在分化良好的肿瘤中也显著增强。采用Mantel-Cox方法比较肿瘤分期、p53蛋白表达和肿瘤血管生成对预后的影响。肿瘤血管生成是我们研究中预测总生存率的最重要的预后指标。p53表达不是独立的，不能提供额外的肿瘤分期的预后信息。我们的研究表明，CD 34染色切片中微血管计数所显示的血管生成是预测胃癌生存率的一个重要预后因素。
Gastric cancer (GC) continues to be a highly aggressive malignancy with poor prognosis and low survival rates. The survival of patients with GC depends mainly on the stage of the disease, with early GC having a 5 year survival of 90-100% and advanced tumors a 5 year survival of 15-25%. The role of other prognostic factors in these tumors is still under investigation. 28 gastric dysplasia, 45 Early GC and 98 Advanced Gastric Cancers were evaluated for expression of the oncogenes p53, c-ErbB2, c-myc and the EGFr in paraffin-embedded material utilizing Avidin-Biotin immunohistochemistry techniques. In 34 cases of GC microvessel density (MVD) was determined in CD34 stained sections. Statistical correlations with stage, histologic type, differentiation degree, location, size, ploidy patterns and overall survival were done. The Mantel-Cox test was performed to evaluate which factors had an independent prognostic value.Both, tumor angiogenesis and p53 protein expression were statistically associated (95% confidence intervals) with overall survival in patients with GC. p53 protein expression was also correlated with cardial location, nodal involvement and tumor stage. c-ErbB2 may recognize a group of highly aggressive well differentiated adenocarcinomas with worse prognosis. c-myc was also significantly enhanced in well differentiated tumors. EGFr showed no significant associations.Mantel-Cox was performed to compare the prognostic value of tumor stage, p53 protein expression and tumor angiogenesis. Tumor angiogenesis was the most important prognostic indicator to predict overall survival in our series. p53 expression was not independent and did not provide additional prognostic information to tumor stage. Our study suggests that angiogenesis as demonstrated by microvessel counts in CD34 stained sections is a significantly important prognostic factor for predicting survival in gastric cancer.