全科医学临床与教育2019年8月第17卷第8期ClinicalEducationofGeneralPracticeAug.2019,Vol.17,No.8·697·
·论著·P53蛋白和Ki-67在上皮性卵巢癌组织中的表达和预后分析
陈赟蔡泓王婷婷[摘要]目的探讨P53、Ki-67在上皮性卵巢癌(EOC)组织中的表达及与患者预后的关系。方法采用免疫组化
检测63例上皮性卵巢组织中P53、Ki-67的表达情况,分析P53、Ki-67表达与EOC患者临床病理特征及预后之间的关系。结果
低分化EOC患者P53阳性表达率明显高于高分化患者,晚期(Ⅲ~Ⅳ期)患者P53阳性表达率高于早
期(Ⅰ~Ⅱ期)患者,差异均有统计学意义(χ2分别=35.23、42.56,P均<0.05);不同年龄及病理类型的EOC患者P53阳性表达率比较,差异无统计学意义(χ2分别=0.41、0.80,P均>0.05)。年龄≤50岁的EOC患者Ki-67阳性表达率明显高于>50岁患者,晚期(Ⅲ~Ⅳ期)患者Ki-67阳性表达高于早期(Ⅰ~Ⅱ期)患者,低、中分化EOC患者Ki-67阳性表达率明显低于高分化患者,差异均有统计学意义(χ2分别=16.75、26.72、47.19,P均<0.05)。COX多因素风险回归分析结果显示:组织分化、临床分期、P53、Ki-67是EOC患者的无进展生存时间(PFS)的影响因素(HR分别=16.28、34.11、12.59、36.52,P均<0.05),且组织分化、临床分期、P53、Ki-67同样是EOC患者的总生存时间(OS)的影响因素(HR分别=10.13、11.05、12.37、25.93,P均<0.05)。结论P53、Ki-67的表达与EOC的发生、发展有密切关
系,可作为EOC患者的预后预测指标。[关键词]
上皮性卵巢癌;P53;Ki-67;免疫组化;预后
ExpressionsofP53andKi-67inepithelialovariancancerandprognosisanalysisCHENYun,CAIHong,WANGTingting.AffiliatedHangzhouFirstPeople’sHospital,SchoolofMedicine,ZhejiangUniversity,Hangzhou310006,China.[Abstract]
Objective
ToinvestigatetheexpressionofP53andKi-67inepithelialovariancancer(EOC)andtheir
relationshipwithprognosis.Methods
TheexpressionofP53andKi-67in63casesofepithelialovariantissuewasde-tectedbyimmunohistochemistry.TherelationshipsbetweentheexpressionsofP53andKi-67andtheclinicopathologicalcharacteristicsandprognosisofEOCpatientswereanalyzed.Results
ThepositiveexpressionrateofP53inpoorlydif-ferentiatedEOCpatientswassignificantlyhigherthanthatinhighlydifferentiatedEOCpatients.ThepositiveexpressionrateofP53inadvancedEOCpatients(Ⅲ~Ⅳstage)washigherthanthatinearlyEOCpatients(Ⅰ~Ⅱstage).Thediffer-enceswerestatisticallysignificant(χ2=35.23,42.56,P<0.05).Therewasnosignificantdifferenceinthepositiveexpre-ssionrateofP53inEOCpatientsamongdifferentagesandpathologicaltypes(χ2=0.41,0.80,P>0.05).Thepositivee-xpressionrateofKi-67inEOCpatientsunder50yearsofagewassignificantlyhigherthanthatinpatientsover50yearsofage.ThepositiveexpressionrateofKi-67inpatientswithadvancedstage(Ⅲ~Ⅳstage)washigherthanthatinpa-tientswithearlystage(Ⅰ~Ⅱstage).ThepositiveexpressionrateofKi-67inpatientswithpoorlydifferentiatedEOCwassignificantlylowerthanthatinpatientswithhighlydifferentiatedEOC(χ2=16.75,26.72,47.19,P<0.05).COXmultivar-iateriskregressionanalysisshowedthattissuedifferentiation,clinicalstage,P53,Ki-67weretheinfluencingfactorsofPFS(HR=16.28,34.11,12.59,36.52,P<0.05),aswellastheOS(HR=10.13,11.05,12.37,25.93,P<0.05).Concl?usion
TheexpressionsofP53andKi-67arecloselyrelatedtotheoccurrenceanddevelopmentofepithelialovarian
cancerandcanbeusedaspredictiveindicatorsforprognosisofpatientswithepithelialovariancancer.
DOI:[Keywords]
epithelialovariancancer;P53;
Ki-67;immunohistochemistry;prognosis
作者单位:10.13558/j.cnki.issn1672-3686.2019.08.008310006浙江杭州,浙江大学医学院附属杭州市第一人民医院妇产科