Expression of P53 predicts treatment failure in aggressive non-Hodgkin's lymphomas
Expression of P53 predicts treatment failure in aggressive non-Hodgkin's lymphomas
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DOI：
10.3109/10428199809058389
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发表时间：
1998-03-01
影响因子：
2.6
通讯作者：
Johnston, JB
中科院分区：
文献类型：
--
作者：
Navaratnam, S;Williams, GJ;Johnston, JB
大约50%的侵袭性非霍奇金淋巴瘤（NHL）患者通过联合化疗达到完全缓解（CR）和治愈。国际指数是预测患者对治疗的耐受性和实现CR的可能性的有用的临床测量，但它不是化学敏感性的直接测量。在这项研究中，我们已经调查了肿瘤抑制基因，p53，作为一个生物标志物的治疗反应在侵略性NHL的预测价值。对50例CHOP方案治疗的侵袭性NHL患者进行回顾性分析。治疗结果与淋巴瘤中p53的表达相关，如使用单克隆抗体Do-7通过常规免疫组织化学测定的。40%的淋巴瘤有>5%的细胞对p53染色阳性，这一发现与治疗反应显著相关。50%的p53阳性肿瘤患者实现了CR，而p53阴性肿瘤患者的CR率为77%。此外，两组的复发率和复发时间也有显著差异。在p53阳性组中，60%的患者在6个月的中位时间内复发，而26%的p53阴性组复发，复发时间>22个月。p53阳性组总生存期（17个月）明显短于p53阴性组（>24个月），提示p53免疫组化检测是判断侵袭性NHL CHOP化疗疗效的一个简单而重要的预后指标。
Approximately 50% of patients with aggressive non-Hodgkin's lymphomas (NHL) achieve a complete remission (CR) and cure with combination chemotherapy. The International index is a useful clinical measure that predicts the patients' tolerance of therapy and likelihood of achieving CR, but it is not a direct measure of chemosensitivity. In this study we have investigated the predictive value of the tumor suppressor gene, p53, as a biological marker for response to treatment in the aggressive NHL. A retrospective study was carried out on 50 patients with aggressive NHL who were treated with CHOP chemotherapy. Treatment outcome was correlated with the expression of p53 in the lymphoma, as measured by routine immunohistochemistry using the monoclonal antibody Do-7. Forty percent of the lymphomas had >5% of the cells staining positively for p53 and this finding correlated significantly with response to treatment. Fifty percent of patients with p53 positive tumors achieved a CR versus 77% of patients with p53 negative tumors. In addition, the relapse rate and time to relapse were significantly different in the two groups. In the p53 positive group, 60% of patients relapsed in a median time of 6 months, whereas 26% of the p53 negative group relapsed with the time to relapse being >22 months. The overall survival of the p53 positive group (17 months) was significantly shorter than that of p53 negative group (>24 months).These results suggest that the immunohistochemical assessment of p53 is a simple and important prognostic measure for patients with aggressive NHL who are treated with CHOP chemotherapy.