Prognostic significance of angiogenesis and Ki-67, p53, and p21 expression:: A population-based endometrial carcinoma study
Prognostic significance of angiogenesis and Ki-67, p53, and p21 expression:: A population-based endometrial carcinoma study
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DOI：
10.1200/jco.1999.17.5.1382
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发表时间：
1999-05-01
影响因子：
45.3
通讯作者：
Akslen, LA
中科院分区：
文献类型：
--
作者：
Salvesen, HB;Iversen, OE;Akslen, LA
目的：对于子宫内膜癌患者，有必要改进高危人群的识别，这些高危人群可能从术后辅助治疗中获益。因此，我们研究了预后的影响标志物的细胞增殖，细胞周期调控，和血管生成的子宫内膜癌患者在人口为基础的setting.Patients和方法：1981年和1985年之间诊断为子宫内膜癌的所有患者在挪威霍达兰县，进行了研究。存活者的中位随访时间为11.5年（范围：8 - 15年），无患者因随访信息不足而失访。石蜡包埋的肿瘤组织，可在96%的情况下（n = 142），进行了微血管密度（MVD）和Ki-67，p53和p21蛋白的表达的免疫组化研究。我们使用热溅射法计算MVD，Ki-67和p21蛋白的表达，因为这种方法可以增加检测可能与预后相关的小侵袭性克隆的概率。单因素生存分析和考克斯回归分析显示，这些肿瘤标志物的重要性与大多数传统的临床病理变量显著相关。年龄、国际妇产科联合会（FIGO）分期、组织学类型、组织学分级、MVD以及Ki-67、p53和p21蛋白表达在单变量分析中均显著影响生存率（P <0.05）。在考克斯回归分析中，年龄、FIGO分期、MVD、Ki-67表达和p53表达是唯一具有独立预后影响的变量（P <或等于0.05），而组织学类型、组织学分级和p21表达没有独立影响。一组高风险的患者与一个以上的不利marker determined.Conclusion：除了年龄和FIGO阶段，MVD，Ki-67，和p53蛋白表达表现出独立的预后影响。因此，在这项基于人群的研究J Clin Oncol 17：1382 - 1390中，来自常规组织学标本的信息确定了一个高危子宫内膜癌患者亚组。(C)1999年，美国临床肿瘤学会。
Purpose: For endometrial carcinoma patients, there is a need for improved identification of high-risk groups that may benefit from postoperative adjuvant therapy. We therefore studied the prognostic impact of markers for cell proliferation, cell-cycle regulation, and angiogenesis among endometrial carcinoma patients in a population-based setting.Patients and Methods: All patients diagnosed with endometrial carcinoma between 1981 and 1985 in Hordaland County, Norway, were studied. The median follow up for the survivors was 11.5 years (range, 8 to 15 years), with no patient lost because of insufficient follow-up information. Paraffin-embedded tumor tissue, available in 96% of the cases (n = 142), was studied immunohistochemically for microvessel density (MVD) and expression of Ki-67, p53, and p21 proteins. We used the hot spat method for calculation of MVD, and expression of Ki-67 and p21 protein, because this approach may increase the probability of detecting small aggressive clones of possible prognostic relevance. The importance of these tumor markers was investigated in univariate survival analyses and Cox regression analysis.Results: The majority of traditional clinicopathologic variables was significantly associated with the tumor biomarkers. Age, International Federation of Gynecology and Obstetrics (FIGO) stage, histologic type, histologic grade, MVD, as well as Ki-67, p53, and p21 protein expression, all significantly influenced survival in univariate analyses (P less than or equal to.05). In the Cox regression analysis, age, FIGO stage, MVD, Ki-67 expression, and p53 expression were the only variables with independent prognostic impact (P less than or equal to.05), whereas histologic type, histologic grade, and p21 expression had no independent influence. A group of high-risk patients with more than one unfavorable marker was identified.Conclusion: In addition to age and FIGO stage, MVD, Ki-67, and p53 protein expression showed an independent prognostic impact. Thus, information derived from routine histologic specimens identified a subgroup of high-risk endometrial carcinoma patients in this population-based study J Clin Oncol 17:1382-1390. (C) 1999 by American Society of Clinical Oncology.