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目的研究抑癌基因蛋白p53、细胞核增殖相关抗原Ki67、耐药基因谷胱甘肽S-转移酶-pi(GST-π)和多药耐药基因MDR-1在卵巢上皮性肿瘤组织中的表达,探讨其表达与卵巢癌临床病理参数及预后的相关性。方法应用免疫组化法检测20例良性肿瘤,20例交界性肿瘤及108例卵巢上皮性癌的卵巢肿瘤组织p53、Ki67、GST-π和MDR-1的表达情况。结果 p53、Ki67、GST-π和MDR-1卵巢交界性肿瘤及上皮性癌中的阳性表达率明显高于良性肿瘤(P<0.01),p53与Ki67之间、Ki67与GST-π之间相关系数差异有统计学意义(P<0.01)。p53蛋白表达与卵巢癌组织分化程度相关系数差异有统计学意义(P<0.01);Ki67与组织分化程度、病理类型及CA125水平相关系数差异有统计学意义(P<0.05),GST-π及MDR-1与卵巢癌临床病理参数相关系数差异无统计学意义(P>0.05)。p53阳性表达患者的无瘤生存时间及总生存时间明显低于p53阴性表达患者(P<0.05),多因素回归显示p53阳性表达可作为预测卵巢癌无瘤生存预后的独立因素(P<0.05)。结论p53、Ki67、GST-π和MDR-1蛋白阳性表达与卵巢癌的发生发展有密切关系,p53可作为预测卵巢癌预后的重要因素。
Objective To study the expression of tumor suppressor gene p53, Ki67, GST-π (multi-drug resistance gene) and multidrug resistance (MDR-1) in ovarian epithelial tumor , To explore its expression and ovarian cancer clinical pathological parameters and prognosis. Methods The expressions of p53, Ki67, GST-π and MDR-1 in 20 cases of benign tumor, 20 cases of borderline tumor and 108 cases of ovarian epithelial carcinoma were detected by immunohistochemistry. Results The positive rates of p53, Ki67, GST-π and MDR-1 in borderline ovarian tumors and epithelial carcinomas were significantly higher than those in benign tumors (P <0.01). The correlations between p53 and Ki67, Ki67 and GST-π There was significant difference in coefficient (P <0.01). The correlation coefficient between p53 protein expression and the degree of ovarian cancer tissue differentiation was statistically significant (P <0.01). The correlation coefficient of Ki67 with histological grade, pathological type and CA125 level was statistically significant (P <0.05) The correlation coefficient between MDR-1 and clinicopathological parameters of ovarian cancer had no statistical significance (P> 0.05). The tumor-free survival time and overall survival time of patients with p53 positive expression were significantly lower than those with p53 negative expression (P <0.05). Multivariate regression analysis showed that p53 positive expression could be used as independent prognostic factor in ovarian cancer-free survival (P <0.05) . Conclusions The positive expressions of p53, Ki67, GST-π and MDR-1 are closely related to the occurrence and development of ovarian cancer. P53 may serve as an important prognostic factor for ovarian cancer.