The prognostic significance of p53 expression quantitated by computerized image analysis in epithelial ovarian cancer
The prognostic significance of p53 expression quantitated by computerized image analysis in epithelial ovarian cancer
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DOI：
10.1097/00004347-199901000-00006
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发表时间：
1999-01-01
影响因子：
2.4
通讯作者：
Syrjänen, KJ
中科院分区：
文献类型：
--
作者：
Anttila, MA;Ji, HX;Syrjänen, KJ
使用静态计算机辅助图像分析系统（CAS 200）评估316例档案上皮性卵巢癌中p53表达的预后意义。使用10%的分界点，26%的原发肿瘤和35%的转移瘤p53蛋白呈阳性。P53阳性与肿瘤分级（p < 0.001）、分期（p < 0.001）、残留肿瘤（p < 0.001）、浆液组织学类型（p = 0.005）、肿瘤复发（p = 0.007）密切相关。总体5年生存率为37%。在单因素生存分析中，高分级、晚期、诊断时年龄较大和肿瘤残留bbb2cm是总生存差的重要预测因素。在总生存率（p < 0.001）和无复发生存率（p < 0.001）中，p53免疫阳性预测预后不良。p53表达是多变量无复发生存的重要预后因素（RR 1.93, p = 0.03），但不是总多变量生存的重要预后因素。此外，p53阳性是高分化或中度分化肿瘤、早期肿瘤或残余肿瘤患者总生存率差的标志。通过CAS定量检测p53免疫表达可能为确定需要更积极的辅助治疗或新的治疗策略的患者提供客观手段。
The prognostic significance of p53 expression in 316 archival epithelial ovarian cancers was assessed using a static, computer-aided image analysis system (CAS 200). Using a 10% cut-off point, 26% of primary tumors and 35% of their metastases were positive for p53 protein. p53 positivity closely correlated with tumor grade (p < 0.001), stage (p < 0.001), residual tumor (p < 0.001), serous histologic type (p = 0.005), and tumor recurrence (p = 0.007). The overall 5-year survival was 37%. In univariate survival analysis, high grade, advanced stage, older age at diagnosis, and residual tumor >2 cm were significant predictors of poor overall survival. In both the overall (p < 0.001) and recurrence-free (p < 0.001) survival, p53 immunopositivity predicted poor prognosis. p53 expression was a significant prognostic factor of multivariate recurrence-free survival (RR 1.93, p = 0.03), but not of overall multivariate survival. In addition, p53 positivity was a marker of poor overall survival in patients with well or moderately differentiated tumors, early stage tumors, or residual tumor. Quantitation of p53 immunoexpression by CAS may offer an objective means to identify patients who need more aggressive adjuvant therapy or new treatment strategies.