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目的探讨原发性腹膜恶性肿瘤p53、Top2α、Ki-67和Her-2/neu的表达及其预测预后的价值。方法对1995年5月至2005年5月在北京大学人民医院治疗的21例原发性腹膜恶性肿瘤患者的石蜡组织标本,用免疫组化技术检测p53、Top2α、Ki-67和Her-2/neu的表达,分析其与化疗疗效和生存时间的关系。结果21例患者Top2α、Ki-67、p53阳性表达率均为52.4%(11/21),8例存在Top2α和Ki-67共表达;Her-2/neu全部呈阴性表达。Top2α与Ki-67表达呈显著的正相关,且均与肿瘤细胞分化等级呈显著正相关。铂类敏感组(10例)和耐药组(8例)p53阳性表达有统计学差异(3例vs7例,P=0.03)。p53阳性表达和阴性表达者的中位无进展生存时间分别为15个月和47个月,两者比较有统计学差异;p53阳性表达对总生存时间以及Top2α、Ki-67阳性表达对中位无进展生存时间和总生存时间均无显著影响。结论原发性腹膜恶性肿瘤组织中存在Top2α、Ki-67与p53的阳性表达,Top2α、Ki-67的表达与肿瘤细胞分化等级呈显著正相关,但对预后可能缺乏显著影响。p53阳性表达者中位无进展生存时间缩短,提示可能对铂类化疗耐药,预后可能较差。
Objective To investigate the expression of p53, Top2α, Ki-67 and Her-2 / neu in primary peritoneal malignant tumors and their prognostic value. Methods The paraffin specimens of 21 patients with primary peritoneal malignant tumor who were treated in Peking University People’s Hospital from May 1995 to May 2005 were detected by immunohistochemistry for p53, Top2α, Ki-67 and Her-2 / neu expression analysis of its relationship with chemotherapy efficacy and survival time. Results The positive rates of Top2α, Ki-67 and p53 were all 52.4% (11/21) in 21 patients. Top2α and Ki-67 were coexpressed in 8 of them and all were negative in Her-2 / neu. There was a significant positive correlation between Top2α and Ki-67 expression, and there was a significant positive correlation between Top2α and tumor grade. The positive expression of p53 in platinum-sensitive group (10 cases) and drug-resistant group (8 cases) was statistically different (3 vs 7 cases, P = 0.03). The median progression-free survival time of patients with p53 positive expression and negative expression were 15 months and 47 months, respectively, with statistical significance; the positive expression of p53 and the expression of Top2α and Ki-67 Progression-free survival and overall survival were not significantly affected. Conclusion There are positive expression of Top2α, Ki-67 and p53 in primary peritoneal malignant tumors. The expression of Top2α and Ki-67 is positively correlated with the grade of tumor cell differentiation, but may have no significant effect on the prognosis. The median progression-free survival of patients with p53 positive expression was shortened, suggesting possible resistance to platinum chemotherapies and poor prognosis.