Prognostic significance of p53, nm23, PCNA and c-erbB-2 in gastric cancer
Prognostic significance of p53, nm23, PCNA and c-erbB-2 in gastric cancer
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DOI：
10.1093/jjco/hyg039
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发表时间：
2003-04-01
影响因子：
2.4
通讯作者：
Kim, JP
中科院分区：
文献类型：
--
作者：
Lee, KE;Lee, HJ;Kim, JP
背景：虽然TNM分期是胃癌最重要的预后因素，但由于同一分期患者的预后存在差异，需要新的预后和预测因素。本研究的目的是阐明p53、nm23、增殖细胞核抗原（PCNA）和c-erbB-2与临床病理参数和生存结果的关系。方法：对1996年7月~ 1997年12月在汉城大学医院行胃癌切除术的841例患者进行胃癌组织中p53、nm23、PCNA和c-erbB-2的免疫组化检测。回顾性分析患者的性别、年龄、手术类型、TNM分期、肿瘤大小、组织学及Lauren分型等临床病理参数。结果：男性568例，女性273例（2.07:1），平均年龄56岁（25 ~ 82岁）。p53、nm23和c-erbB-2的阳性表达率分别为43%、74%和17%；59%的肿瘤表达PCNA inclx大于等于50。p53表达与年龄、性别、肿瘤大小、组织学、Lauren分型、分期、nm23表达、PCNA指数≥50、c-erbB-2表达有关。nm23表达与年龄、肿瘤大小、Borrmann型、组织学、Lauren分型及分期有关。PCNA指数≥50与年龄、性别、肿瘤大小、Borrmann型、组织学、Lauren分型及c-erbB2表达有关。c-erbB-2表达与性别、Borrmann型、组织学及Lauren分型有关。单因素分析显示，P53、nm23与预后不良相关。单因素亚组分析显示，nm23与III期及弥漫性胃癌预后不良相关。然而，在一项多变量研究中，这些预后影响并没有得到维持。结论：p53和nm23的表达可能与胃癌切除术后患者预后不良有关。然而，多变量分析并未揭示其预后意义。
Background: Although the TNM stage is the most important prognostic factor for gastric cancer, there is a need for new prognostic and predictive factors, because the prognosis varies among patients of the same stage. The purpose of this study was to clarify the relationship of p53, nm23, proliferating cell nuclear antigen (PCNA) and c-erbB-2 with the clinicopathological parameters and the survival results.Methods: For 841 patients who had undergone gastrectomy for gastric cancer at Seoul National University Hospital from July 1996 to December 1997, the expression levels of p53, nm23, PCNA and c-erbB-2 in gastric cancer tissues were examined immunohistochemically. Also, the clinicopathological parameters such as gender, age, operation type, TNM stage and size of the tumor, histology and Lauren classification were analyzed retrospectively.Results: There were 568 males and 273 females (2.07:1) with a mean age of 56 years (range: 25-82 years). The percentages of positive expression of p53, nm23 and c-erbB-2 were 43, 74 and 17%, respectively; 59% of tumors expressed PCNA inclex greater than or equal to50. p53 expression was associated with age, gender, tumor size, histology, Lauren classification, stage, nm23 expression, PCNA index greater than or equal to50 and c-erbB-2 expression. nm23 expression was associated with age, tumor size, Borrmann type, histology, Lauren classification and stage. PCNA index greater than or equal to50 was associated with age, gender, tumor size, Borrmann type, histology, Lauren classification and c-erbB2 expression. c-erbB-2 expression was associated with gender, Borrmann type, histology and Lauren classification. p53 and nm23 were related with poor prognosis in univariate analysis. nm23 was related with poor prognosis of stage III and diffuse-type gastric cancer in univariate subgroup analysis. However, in a multivariate study, these prognostic impacts were not maintained.Conclusion: The expression of p53 and nm23 seems to be related with poor prognosis of gastric cancer patients who have undergone gastrectomy. However, the prognostic significance was not revealed by a multivariate analysis.