卵巢浆液性腺癌中SP1、KLF4和p21表达及其预后意义

Expression and prognostic significance of SP1,KLF4 and p21 in ovarian serous carcinoma

目的探讨不同级别卵巢浆液性腺癌中SP1、KLF4和p21蛋白表达的差异和预后意义。方法应用免疫组化EliVision法检测卵巢低级别和高级别浆液性腺癌中SP1、KLF4和p21蛋白的表达,Kaplan-Meier单因素和Cox多因素生存分析其与患者预后的关系。结果 SP1、KLF4和p21蛋白在高级别浆液性腺癌中的阳性率分别为74.5%、17.0%和11.7%,低级别浆液性腺癌中的阳性率分别为65.2%、34.8%和26.1%,与对照组相比,SP1表达均明显升高(P<0.05),而KLF4和p21表达均明显降低(P<0.05)。三者在高、低级别液性腺癌中的表达差异无显著性(P>0.05)。SP1、KLF4和p21蛋白表达与高级别液性腺癌FIGO分期密切相关,且SP1还与术后有无残留灶密切相关(P<0.05)。卵巢高级别液性腺癌中SP1表达与KLF4、p21的表达均呈显著负相关(P<0.05)。高级别液性腺癌中SP1蛋白阳性者的5年生存率明显低于阴性者,而KLF4和p21蛋白阳性者的5年生存率明显高于阴性者(P<0.05)。Cox多因素分析显示,FIGO分期和SP1高表达是影响高级别浆液性腺癌预后的独立因素。结论 SP1蛋白过表达以及KLF4和p21蛋白低表达,参与了高、低级别浆液性腺癌的发生,三者表达与高级别浆液性腺癌的预后有关,且SP1是独立预后因素。

Purpose To explore the difference of expres- sion and prognostic significance of SP1, KLF4 and p21 in low grade ovarian serous carcinoma （LGSC） and high grade ovarian serous carcinoma （HGSC）. Methods The expression of SP1, KLF4 and p21 protein was examined with immunohistochemistry EliVision method in cases with LGSC and HGSC. Kaplan-Meier analysis and Cox multivariate survival analysis were used to as- sess the impact of SP1, KLF4 and p21 expression on prognosis of LGSC and HGSC. Results SP1, KLF4 and p21 expression were detected respectively in 74. 5% , 17.0% and 11.7% HG- SC cases, and in 65.2% , 34. 8% and 26. 1% LGSC cases. Compared to control group, the expression level of SP1 was sig- nificantly higher （ P 〈 0. 05 ）, but the expression level of KLF4 and p21 were significantly lower （P 〈 0. 05 ）. There was no sig- nificant difference of SP1, KLF4 and p21 expression between HGSC and LGSC （P 〉 0. 05 ）. The expression of SP1, KLF4and p21 were associated with FIGO stage, meanwhile SP1 asso- ciated with residual tumor size in HGSC （ P 〈 0.05 ）. There was a significant negative correlation between SP1 and KLF4, p21 proteins in HGSC （P 〈 0. 05 ）. Kaplan-Meier analysis revealed that there were significantly poor overall smwival （ OS ） of 5 years for patients with HGSC displaying high expression of SP1, or low expression of KLF4 and p21 （P 〈0.05 ） , but no signifi- cantly improved OS for patients with LGSC （ P 〉 0. 05 ）. Cox a- nalysis showed that SP1 overexpression is an independent prog- nosis factor for HGSC. Conclusion Overexpression of SP1 and low expresion of KLF4 and p21 contribute to carcinogenesis of HGSC and LGSC. They are associated with a poor prognosis of HGSC, but not LGSC, meanwhile SP1 is an independant prog- nosis factor for HGSC.