Prognostic implications of p53 protein, epidermal growth factor receptor, and Ki-67 labelling in brain tumours.
Prognostic implications of p53 protein, epidermal growth factor receptor, and Ki-67 labelling in brain tumours.
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DOI：
10.1038/bjc.1992.273
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发表时间：
1992-08
影响因子：
8.8
通讯作者：
Pearson, A D
中科院分区：
文献类型：
--
作者：
Jaros, E;Perry, R H;Adam, L;Kelly, P J;Crawford, P J;Kalbag, R M;Mendelow, A D;Sengupta, R P;Pearson, A D
应用免疫组化方法检测了16例人脑肿瘤（包括43例星形细胞瘤）活检标本中p53蛋白、表皮生长因子受体（EGFR）和Ki-67核抗原的表达。P53蛋白，几乎可以肯定是其突变形式，在16种肿瘤中的7种中表达，EGFR在16种肿瘤中的11种中表达。在星形细胞瘤中，表达p53或EGFR的肿瘤比例随着恶性程度的增加而增加，平均Ki-67标记指数（LI）也是如此：1级p53-0%，2级17%，3级38%，4级65%; 1级EGFR-0%，2级33%，3级85%，4级95%; 1级和2级的平均Ki-67 L1-1.1%，3级8.3%，4级13.4%。p53和EGFR阳性的星形细胞瘤Ki-67阳性率分别为11.8%和10.7%，P <0.05。而未做手术者分别为6.2%和4.1%。表达p53或EGFR的星形细胞瘤患者的生存率显著降低（分别为P = 0.035和P = 0.007）：在诊断后100周，p53 + ve患者和EGFR + ve患者中仅有11%和13%存活，而p53-ve患者和EGFR-ve患者中分别有36%和60%存活。Ki-67 LI大于5%的患者生存率降低（P小于0.0001）-诊断后无一存活超过86周，而63%阳性细胞小于5%的患者在100周时仍存活。单因素分析显示，星形细胞瘤中p53突变体、EGFR蛋白和Ki-67表达大于5%与恶性进展和预后不良相关。多因素分析显示，只有肿瘤分级和Ki-67 LI是生存的独立预后因素。
The expression of p53 protein, epidermal growth factor receptor (EGFR), and Ki-67 nuclear antigen was examined by immunohistochemistry in biopsies of 16 types of human brain tumours, including 43 astrocytomas. P53 protein, almost certainly its mutant form, was expressed in seven of the 16, and EGFR in 11 of the 16 types of tumours. In astrocytomas both the proportion of tumours which expressed p53 or EGFR increased with grade of malignancy as did the mean Ki-67 labelling index (LI): p53-0% in grade 1, 17% in grade 2, 38% in grade 3, 65% in grade 4; EGFR-0% in grade 1, 33% in grade 2, 85% in grade 3, 95% in grade 4; mean Ki-67 L1-1.1% in grades 1 and 2, 8.3% in grade 3, and 13.4% in grade 4. Astrocytomas which expressed p53 or EGFR had a significantly higher Ki-67 LI at P less than 0.05 (11.8% and 10.7%, resp.) than those that did not (6.2% or 4.1%, resp.). Patients with astrocytomas expressing p53 or EGFR had a significantly reduced survival (P = 0.035 and P = 0.007, resp.): only 11% of the p53 + ve and 13% of the EGFR + ve patients were alive at 100 weeks following diagnosis compared to 36% of p53-ve or 60% of EGFR-ve patients. Patients with Ki-67 LI greater than 5% had a reduced survival (P less than 0.0001)--none survived beyond 86 weeks following diagnosis, whilst 63% of patients with less than 5% positive cells were still alive at 100 weeks. The univariate analysis showed that in astrocytomas expression of p53 mutants, EGFR protein, and Ki-67 greater than 5% are associated with malignant progression and poor prognosis. The multivariate analysis revealed that only tumour grade and Ki-67LI were independent prognostic factors for survival.