- 期刊
Prognostic Evaluation in Supratentorial Astrocytic Tumors Using P53, Epidermal Growth Factor Receptor, C-Erb B-2 Immunostaining
以p53、上皮生長因子受器及c-erbB-2免疫染色評估天幕上區星狀細胞瘤患者的預後
摘要
分子病理學對於預測腫瘤患者預後扮演著重要的角色，其中以p53、上皮生長因子受器(epidermal growth factor receptor)和c-erbB-2的研究較為廣泛。本研究分析六個預後因子(年齡、性別、組織惡性度分級、p53、上皮生長因子受器、c-erbB-2)對於天幕上區星狀細胞瘤患者預後的影響。本研究收集37例星狀細胞瘤，包括9例分化良好星狀細胞瘤(WHO第2級)，19例分化不良星狀細胞瘤(WHO第3級)，和9例最惡性的多形性神經膠母細胞瘤(WHO第4級)。在單變項分析中，對預後無統計學意義者包括：性別(p=0.2188)，年齡(p=0.5530)，p53免疫染色(p=0.2194)，和c-erbB-2蛋白免疫染色(p=0.4203)；而組織惡性度分級(p=0.0049)與上皮生長因子受器免疫染色(p0.0284)對預後評估有統計學上的意義。在多變項分析中，只有組織惡性度分級表現出有意義的獨立變項(p=0.0152)。在WHO第2級和第3級星狀細胞瘤中，p53或上皮生長因子受器的表現和預後不好有關。在多形性神經膠母細胞瘤中，p53和預後不好有關。本研究顯示，組織惡性度分級是天幕上區星狀細胞瘤預後預測最好的指標。P53或上皮生長因子受器和預後有關，但無統計學的意義。
關鍵字
無資料並列摘要
Molecular pathology may play an important role in predicting the tumor prognosis, particularly p53, epidermal growth factor receptor (EGFR), and c-erbB-2. We investigated six variables (age, sex, histopathological grade, p53, EGFR, and c-erbB-2) to identify the role of such factors in predicting the outcome of patients with supratentorial astrocytic tumors. Thirty-seven tumors were studied including 9 well-differentiated astrocytomas (WHO grade 2), 19 anaplastic astrocytomas (WHO grade 3), and 9 glioblastomas multiforme (WHO grade 4). In univariate analysis, no statistical significance was found for the prognostic value of the sex (p=0.2188), age (p=0.5530), p53 immunostain (p=0.2194), and c-erbB-2 immunostain (p=0.4203). A significant correlation with the prognosis was found with respect to the histopathological grade (p=0.0049) and EGFR expression (p=0.0284). In multivariate analysis, the histopathological grade was shown to be significant independent variable (p=0.0152). In WHO grade 2 and 3 astrocytomas, expression of p53 or EGFR was associated with poorer patient outcome. In glioblastomas, expression of p53 was also associated with poorer prognosis. Our studies suggested that conventional histological assessment of supratentorial astrocytic tumors remains the best guide to prognosis. Althouth no statistical significance was found between the immunostains and survival in variant grades of astrocytomas, there was a trend between p53 or EGFR proteins expression and the decrease of survival time.
延伸閱讀
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