P16 loss and mitotic activity predict poor survival in patients with peritoneal malignant mesothelioma
P16 loss and mitotic activity predict poor survival in patients with peritoneal malignant mesothelioma
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DOI：
10.1158/1078-0432.ccr-04-1884
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发表时间：
2005-05-01
影响因子：
11.5
通讯作者：
Powell, CA
中科院分区：
文献类型：
--
作者：
Borczuk, AC;Taub, RN;Powell, CA
目的：腹膜恶性间皮瘤是一种侵袭性肿瘤，强化治疗可提高部分患者的存活率。我们假设病理变量会将患者分为有利和不利两个亚组。实验设计：对1995-2003年间54例腹膜恶性间皮瘤患者进行三联疗法的评估。结果：未接受三联疗法的患者死亡风险显著增加[危险比(HR)9.6；4.321.6；P<；0.0001]。双相组织学也与死亡风险的增加有关(HR，8.5%；3.421.8；P<；0.0001)。在调整治疗方式和组织类型的多因素分析中，高有丝分裂率和p16缺失与死亡风险增加相关(HR，3.074；1.05-9.0；P<；0.04；HR，3.65；1.3-10.2；P<；0.014)。结论：双相组织学、有丝分裂增高和p16缺失与腹膜恶性间皮瘤较差的生存独立相关。在接受三联体治疗的患者中，有丝分裂率增加与死亡风险增加有关。
Purpose: Peritoneal malignant mesothelioma is an aggressive neoplasm for which intensive therapy improves survival in a subset of patients. We hypothesized that pathologic variables would stratify patients into favorable and unfavorable survival subgroups.Experimental Design: Fifty-four patients with peritoneal malignant mesothelioma were evaluated for trimodal therapy from 1995 to 2003. Two pathologists evaluated pathologic variables independently, and p16 status was analyzed by immunohistochemistry.Results: Patients not receiving trimodal therapy had a significantly increased risk of death [hazard ratio (HR), 9.6; 4.3-21.6; P < 0.0001]. Biphasic histology was also associated with increased risk of death (HR, 8.5; 3.4-21.8; P < 0.0001). In multivariate analysis adjusting for treatment modality and histologic type, high mitotic rate and p16 loss were associated with increased risk of death (HR, 3.074;1.05-9.0; P < 0.04 and HR, 3.65;1.3-10.2; P < 0.014, respectively).Conclusions: Biphasic histology, increased mitotic rate, and p16 loss were independently associated with poorer survival in peritoneal malignant mesothelioma. Among the trimodal treated patients, increased mitotic rate was associated with increased risk of death.