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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。
To investigate the relationship between cell proliferation activity, P53 gene mutation and the occurrence, development and prognosis of ovarian mucinous cystadenocarcinoma. Methods: The expressions of Ki-67 antigen and P53 protein in 42 cases of ovarian mucinous cystadenocarcinoma, 10 cases of mucinous borderline tumor and 16 cases of mucinous cystadenoma were detected by immunohistochemical staining. Results: The MIB1 index of ovarian mucinous cystadenocarcinoma was significantly higher than that of borderline and cystadenoma (P <0.01). The number of MIB1 correlated with the tumor stage, grade and the size of postoperative residual tumor (P <0.05) ). The positive rate of P53 protein in ovarian mucinous cystadenocarcinoma was 28.6%. The positive expression of P53 was correlated with tumor grade and MIB1 index (P <0.05). The Kaplan-Meier survival curve and log-rank test showed that the MIB1 index ≥14.2%, or the survival rate of P53 positive expression were significantly lower (P <0.05). Using the Cox proportional hazard model, risk of death for MIB1 ≥ 14.3% was 3.7 times more likely to be fatal than that for MIB1 <14.2% (P <0.01), and P53 positive for death was negative 4.7 times (P <0.01). CONCLUSION: The detection of Ki-67 antigen and P53 protein in ovarian mucinous cystadenocarcinoma paraffin sections by MIBI or P53 monoclonal antibody is of great significance in determining the degree of tumor differentiation, biological behavior and prognosis.