Clusterin expression predicts survival of invasive cervical cancer patients treated with radical hysterectomy and systematic lymphadenectomy
Clusterin expression predicts survival of invasive cervical cancer patients treated with radical hysterectomy and systematic lymphadenectomy
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DOI：
10.1016/j.ygyno.2007.11.026
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发表时间：
2008-03-01
影响因子：
4.7
通讯作者：
Sakuragi, Noriaki
中科院分区：
文献类型：
--
作者：
Watari, Hidemichi;Ohta, Yoko;Sakuragi, Noriaki
目标.本研究的目的是评估clusterin表达在浸润性宫颈癌患者行广泛子宫切除术和系统性淋巴结切除术后的预后意义。浸润性宫颈癌标本来自1997年至2004年在北海道大学医院接受广泛子宫切除术和系统性淋巴结切除术的52例患者。用免疫组织化学染色法检测clusterin蛋白的表达。结果进行了评价与几个临床病理因素。生存分析采用Kaplan-Meier曲线和对数秩检验。多因素考克斯回归分析确定独立的预后因素。子宫颈癌细胞胞浆中有促癌素蛋白表达。clusterin蛋白在浸润性宫颈癌组织中的表达与临床病理因素无关。clusterin阳性表达的患者预后明显差于clusterin阴性表达的患者（p = 0.017）。包括clusterin表达在内的多变量分析显示，clusterin表达（p = 0.006）和阳性淋巴结组数（p = 0.002）是影响生存率的独立预后因素。根据clusterin表达和阳性淋巴结组的数量，浸润性宫颈癌患者的生存率可分为三组，无或有一个阳性淋巴结组（A组）的5年生存率估计为100.0%，多个淋巴结组（B组）的5年生存率估计为78.7%，而在多个淋巴结组（C组）中有14.3%的人有阳性的clusterin表达（A组与B组p = 0.03，B组与C组p = 0.004，P
Objectives. The aim of this study was to evaluate the prognostic significance of clusterin expression in invasive cervical cancer patients treated with radical hysterectomy and systematic lymphadenectomy.Methods. Invasive cervical cancer specimens were obtained from 52 patients who underwent radical hysterectomy and systematic lymphadenectomy at Hokkaido University Hospital from 1997 to 2004. The expression of clusterin protein was analyzed by inummohistochemical staining. Findings were evaluated in relation to several clinicopathological factors. Survival analyses were performed by the Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by multivariate Cox regression analysis.Results. Clusterin protein was present in the cytoplasm of cervical cancer cells. The expression of clusterin protein in invasive cervical cancer tissues was not related to any clinicopathologic factors analyzed. Patients with positive clusterin expression showed significantly worse prognosis than those with negative clusterin expression (p=0.017). Multivariate analysis including clusterin expression revealed that clusterin expression (p=0.006) and the number of positive node groups (p=0.002) were independent prognostic factors for survival. Survival of patients with invasive cervical cancer could be stratified into three groups by combination of clusterin expression and number of positive node groups with an estimated 5-year survival rate of 100.0% for no or one positive node group irrespective of clusterin expression (group A), 78.7% for multiple node groups with negative clusterin expression (group B), and 14.3% for multiple node groups with positive clusterin expression (group C) (p=0.03 for group A vs. group B, p=0.004 for group B vs. group C, and p