p53 and VEGF expression are independent predictors of tumour recurrence and survival following curative resection of gastric cancer.
p53 and VEGF expression are independent predictors of tumour recurrence and survival following curative resection of gastric cancer.
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DOI：
10.1038/sj.bjc.6601455
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发表时间：
2004-01-12
影响因子：
8.8
通讯作者：
Pera, M
中科院分区：
文献类型：
--
作者：
Fondevila, C;Metges, J P;Fuster, J;Grau, J J;Palacin, A;Castells, A;Volant, A;Pera, M
本研究旨在探讨肿瘤微血管密度（MVD）、p53和血管内皮生长因子（VEGF）表达在胃癌根治术后的预后判断中的价值。总共有156例根治性切除的胃癌患者构成了这项盲法回顾性评价的基础。患者接受单独手术（n=53）或手术加辅助化疗（n=103）治疗。采用免疫组化法检测肿瘤MVD、p53表达和VEGF表达。平均随访43个月后，64例（41%）患者死亡，55例（35%）患者肿瘤复发。MVD与p53（P=0.005）和VEGF（P=0.005）的表达呈正相关。MVD ≥ 100（P=0.05）和VEGF阳性表达（P<0.02）均与较短的无病生存期相关，VEGF阳性表达（P=0.01）也与较短的总生存期相关。多变量分析证实，除了肿瘤病理分期、淋巴结比例、淋巴结切除范围和神经周围浸润、p53表达和VEGF表达与无病生存期（分别为P<0.0005和0.02）和总生存期（分别为P<0.02和0.01）独立相关。最后，与那些表达p53的患者相比，肿瘤未显示p53表达的患者在接受辅助化疗时具有生存益处本研究表明，p53表达和VEGF表达是胃癌根治性切除患者无病生存期和总生存期的独立预后因素，并且p53状态也可能影响对化疗的反应。
This study was undertaken to determine the value of tumour microvessel density (MVD) and the expression of p53 and vascular endothelial growth factor (VEGF) as prognostic markers in patients with gastric cancer operated on for cure. In all, 156 patients with curatively resected gastric cancer constituted the basis of this blinded retrospective evaluation. Patients were treated with either surgery alone (n=53) or surgery plus adjuvant chemotherapy (n=103). Tumour MVD, p53 expression, and VEGF expression were assayed using immunohistochemical techniques. After a mean follow-up of 43 months, 64 (41%) patients had died and 55 (35%) patients developed tumour recurrence. Positive correlations between MVD and both p53 (P=0.005) and VEGF (P=0.005) expression were observed. Both MVD ⩾100 (P=0.05) and positive VEGF expression (P<0.02) were associated with shorter disease-free survival, and positive VEGF expression (P=0.01) was also associated with shorter overall survival. Multivariate analysis confirmed that, in addition to the pathological tumour stage, lymph node ratio, the extent of lymphadenectomy and perineural invasion, p53 expression, and VEGF expression were independently associated with both disease-free survival (P<0.0005 and 0.02, respectively) and overall survival (P<0.02 and 0.01, respectively). Finally, patients whose tumours did not show p53 expression had a survival benefit compared to those expressing p53 when treated with adjuvant chemotherapy (P=0.01).This investigation demonstrates that p53 expression and VEGF expression are independent prognostic factors for both disease-free survival and overall survival in patients with curatively resected gastric cancer, and that p53 status may also influence response to chemotherapy.