p53,Ki67,GST-π和MDR-1在卵巢上皮性肿瘤中的表达及意义

The Expression and Significance of p53,Ki67,GST-π and MDR-1 Protein in Epithelial Ovarian Tumors

目的研究抑癌基因蛋白p53、细胞核增殖相关抗原Ki67、耐药基因谷胱甘肽S-转移酶-pi(GST-π)和多药耐药基因MDR-1在卵巢上皮性肿瘤组织中的表达,探讨其表达与卵巢癌临床病理参数及预后的相关性。方法应用免疫组化法检测20例良性肿瘤,20例交界性肿瘤及108例卵巢上皮性癌的卵巢肿瘤组织p53、Ki67、GST-π和MDR-1的表达情况。结果 p53、Ki67、GST-π和MDR-1卵巢交界性肿瘤及上皮性癌中的阳性表达率明显高于良性肿瘤(P<0.01),p53与Ki67之间、Ki67与GST-π之间相关系数差异有统计学意义(P<0.01)。p53蛋白表达与卵巢癌组织分化程度相关系数差异有统计学意义(P<0.01);Ki67与组织分化程度、病理类型及CA125水平相关系数差异有统计学意义(P<0.05),GST-π及MDR-1与卵巢癌临床病理参数相关系数差异无统计学意义(P>0.05)。p53阳性表达患者的无瘤生存时间及总生存时间明显低于p53阴性表达患者(P<0.05),多因素回归显示p53阳性表达可作为预测卵巢癌无瘤生存预后的独立因素(P<0.05)。结论p53、Ki67、GST-π和MDR-1蛋白阳性表达与卵巢癌的发生发展有密切关系,p53可作为预测卵巢癌预后的重要因素。

Objective To explore expression level of p53,Ki67,GST-π and MDR-1 protein in epithelial ovarian tumors and its correlation with clinicopathological parameters and prognosis of epithelial ovarian tumors.Methods Immunohistochemical method was used to detect the expression level of p53,Ki67,GST-π and MDR-1 protein in 148 tumor tissues including 20 benign tumors,20 borderline tumors and 108 epithelial ovarian tumors.Results The positive rates of p53,Ki67,GST-π and MDR-1 in borderline and malignant tumors were higher than those in benign tumors(P<0.01).Significant correlations were observed between p53 and Ki67(P<0.01),so did Ki67 and GST-π(P<0.01).The expression of p53 in ovarian cancer was correlated with histological grade(P<0.01),and expression of Ki67 protein was correlated with histological grade,histological type and CA125 level(all P<0.05).There was no significant relationship between the expression of GST-π,MDR-1 and clinicopathological parameters(P>0.05).Patients with positive expression of p53 demonstrated a significantly worse prognosis than that of patients with negative p53 expression for disease-free survival time and overall survival time(both P<0.05).It was revealed by multivariate regression analysis that the positive expression rate of p53 could be an independent factor for predicting the disease-free survival time of epithelial ovarian tumors(P<0.05).Conclusion The expression of p53,Ki67,GST-π and MDR-1 protein was significantly associated with the development and progression of epithelial ovarian cancer.p53 may be an important prognostic factor for survival of patients with epithelial ovarian cancer.