Ki-67抗原与P_(53)蛋白在卵巢粘液性肿瘤中的表达及其临床意义

Ki-67 antigen and P_(53) protein in mucinous ovarian tumor and their clinical value

探讨细胞增殖活性及Ｐ５３基因突变与卵巢粘液性囊腺癌发生、发展及预后的关系。方法：用免疫组化染色法检测卵巢粘液性囊腺癌４２例、粘液性交界性瘤１０例及粘液性囊腺瘤１６例肿瘤组织中Ｋｉ－６７抗原及Ｐ５３蛋白过度表达情况。结果：卵巢粘液性囊腺癌的ＭＩＢ１指数明显高于交界性瘤和囊腺瘤（Ｐ＜０．０１），ＭＩＢ１数与肿瘤分期、分级、术后残余癌灶大小相关（Ｐ＜０．０５）。卵巢粘液性囊腺癌的Ｐ５３蛋白阳性表达率为２８．６％，Ｐ５３阳性表达与肿瘤分级、ＭＩＢ１指数明显相关（Ｐ＜０．０５）。经Ｋａｐｌａｎ－Ｍｅｉｅｒ生存率曲线和Ｌｏｇ－ｒａｎｋ检验分析发现ＭＩＢ１指数≥１４．２％，或Ｐ５３蛋白阳性表达者生存率均明显降低（Ｐ＜０．０５）。用Ｃｏｘ比例风险模型计算，ＭＩＢ１指数≥１４．３％者死亡危险性是ＭＩＢ１指数＜１４．２％者的３．７倍（Ｐ＜０．０１），Ｐ５３蛋白阳性的死亡危险性是阴性患者的４．７倍（Ｐ＜０．０１）。结论：用ＭＩＢＩ或Ｐ５３单抗检测卵巢粘液性囊腺癌石蜡切片中的Ｋｉ－６７抗原和Ｐ５３蛋白，对判断肿瘤的分化程度，生物学行为和预后，具有一定意义。

The purpose of this work was to study the relationship between cell proliferation and P53 gene mutation with the occurrence, expansion and prognosis of cystadenocarcinomas. MIB1,which is a new monoclonal antibody against Ki-67, and P53 protein (antibody) were used to make an immunohistochemical study on 68 cases of mucinous ovarian tumors. These cases included 42 cyst adenocarcinomas, 10 borderline tumors and 16 cystadenomas. Results: Compared with cystadenomas and borderline tumors, the MIB1 proliferation index was significantly higher in cystadenocarcinomas (P<0.01). In mucinous cystadenocarcinomas, The MIBI proliferation index was clearly associated with tumor stage, histological grade and residual disease (P<0.05). Immunohistochemical staining of P53 protein was positive in 28.6% of cystadenocarcinomas (P<0.05).P53 overexpre ssion was closely related to histological grade and MIB1 index(P<0.05), but not to tumor stage and residual disease. The survival rate of patients with MIB1 index>14.2% and positive P53 Protein expression was significantly lower than that of those patients with MIB1 index<14.2% and negative P53 expression (P<0.05). atients with MIB1 index >14.2% had a 3.7 fold increased risk of death as compared with patients with MIB1 index <14.2%(P<0.01). Patients with positive P53 protein expression had a 4.7-fold increased risk of death as compared with patients with negative P53 expression(P<0.01) (Cox proportional hazards model was used.) Conclusions: The use of Ki-67 antigen and P53 protein detection on mucinous ovarian cystadenocarcinoma section could be used to determine the differentiation and prognosis of tumors.