卵巢上皮性癌雌激素受体、孕激素受体和P53的表达与其预后的关系

Prognostic Significance of Expression of ER,PR and P53 in Epithelial Ovarian Cancer

目的：探讨卵巢上皮性癌雌激素受体（ER）、孕激素受体（PR）和P53蛋白的表达特点及与生存时间的关系。方法：应用免疫组化法检测70例卵巢上皮性癌组织ER、PR和P53阳性表达情况，分析其与临床病理特征的关系，并对其与生存率的关系进行单因素及多因素分析。结果：①70例卵巢上皮性癌组织中，ER表达阳性29例（41．4％），PR表达阳性30例（42．9％），P53蛋白表达阳性4l例（58．6％）。PR阳性表达在年龄、月经状态和组织学类型的比较中，差异有统计学意义（P=0．027；P=0．025；P=0．005）。ER和P53阳性表达在各项临床病理特征的比较中，差异均无统计学意义（P〉0．05）。②单因素分析显示，不同年龄、残余肿瘤灶直径、FI—GO分期、组织学分级和PR阳性表达患者的3年生存率分别比较，差异均有统计学意义（P〈0．05）。③多因素分析显示，残余肿瘤灶直径是影响生存率的独立危险因素（RR5．058，95％CI1．658—15．434），而PR则是独立的保护因素（RR0．254，95％C10．071—0．909）。结论：年轻、未绝经、浆液性癌患者的PR阳性表达比例明显增高，PR阳性表达是卵巢上皮性癌独立的保护因素。ER和P53蛋白表达不是影响卵巢上皮性癌生存率的重要因素。

Objective：To evaluate the expression and prognostic significance of estrogen receptor（ER）, progesterone receptor（PR） and P53 in epithelial ovarian cancer（EOC）. Methods. EOC tissues from 70 pa- tients staged I - IV were analyzed immunohistochemically for expression of ER, PR and P53. The correlation with clinicopathological factors were evaluated with X2 test. Univariate and multivariate method were used for identifying their prognostic values. Results： of 70 EOC patients,29 （41.1% ） were staining positive for ER,30 （42.9%）were positive for PR,and 41 （58. 6%）were positive for P53. Tumors staining positive for PR were detected increased in the subgroup less than 52 years old （ P = 0. 027）, premenopausal women （ P = 0. 025 ）, and the patients with serous carcinoma（ P =0. 005）. ER and P53 expression showed no association with clin- icopathological factors. Age, residual disease, FIGO stage, histological grade and PR expression were found to be of prognostic significance on univariate analysis（ P 〈0. 05）. Multivariate analysis revealed that residual disease（ RR 5. 058,95% CI 1. 658 - 15. 434） ） was an independent risk factor for overall survival, while PR expression played an independent positive prognostic role （ RR 0. 254,95% CI 0. 071 - 0. 909）. Conclu- sions：Positive staining of PR is an independent and significant prognostic predictor,which were more preva- lent among younger,premenopausal patients and women with serous carcinoma. ER or P53 expression had no prognostic value in ovarian cancer.