The Relationship of p53 Accumulation and DNA Ploidy and Conventional Clinicopathological Prognostic Variables in Patients with Ovarian Carcinoma

Zusammenfassung

Fragestellung: Es wurde das Verhältnis der p53-Akkumulation und DNA-Ploidie zu herkömmlichen prognostischen Indikatoren bei Patienten mit Ovarialkarzinom untersucht. Material und Methodik: Das Tumormaterial (n = 188) wurde in Bezug auf die durchflusszytometrische DNA-Ploidie und auf die immunohistochemische Akkumulation des p53-Proteins analysiert. Dementsprechend wurden die Pearson Korrelation, Fisher's Exact Test, Cox's Regressionsanalyse und die Kaplan-Meier Überlebensmethode verwendet. Ergebnisse: Die p53-Akkumulation und Aneuploidie waren häufiger bei Patienten mit seröser Histologie, einem fortgeschrittenen FIGO-Stadium mit ungünstigem Grad, und die eine positive peritoneale Zytologie und ein Wiederauftreten des Tumors aufwiesen. Das Alter der Patienten, Stadium, Grad, Resttumor, positive peritoneale Zytologie und Gesamtüberlebensrate korrelierten mit der DNA-Ploidie und der p53-Akkumulation. Es wurde keine signifikante Assoziation des histologischen Subtyps mit p53 und der DNA-Ploidie beobachtet. p53 und DNA-Ploidie waren stark korreliert. Es stellte sich in Univarianzanalyse heraus, dass p53 und DNA-Ploidie wichtige Bestimmungsfaktoren des Wiederauftretens waren. Von den analysierten Faktoren war p53 der signifikant stärkere unabhängige Prädiktor für ein Wiederauftreten des Tumors. Wurde Überleben als Endpunkt der Multivarianzanalyse gesetzt, waren Alter, Grading, Tumorrest und DNA-Ploidie unabhängige Prognosezeichen. Schlussfolgerung: p53-Akkumulation und DNA-Ploidie korrelieren mit FIGO-Stadium, Grad, peritonealer Zytologie, Tumorwiederauftreten und Gesamtüberlebensrate. p53 war der stärkere unabhängige bestimmende Faktor für ein Tumorwiederauftreten, während DNA-Ploidie der stärkere unabhängige Prognosefaktor für die Gesamtüberlebensrate war. Da die DNA-Ploidie und die p53-Akkumulation bei Univarianz- und Multivarianzanalysen bedeutende Faktoren für die Gesamtüberlebensrate waren, können sie nützliche Faktoren für die Prognosestellung sein.

Abstract

Objective: To determine whether p53 expression and DNA ploidy were related to traditional prognostic indicators in patients with ovarian cancer. Methods: Tumour material (n = 188) was analysed regarding flow cytometric DNA ploidy and the immunohistochemical p53 expression. Pearson correlation, Fisher's exact test, Cox's regression analysis and Kaplan-Meier survival tests were used, as appropriate. Results: p53 accumulation and aneuploidy were more frequent in patients with serous histology, FIGO advanced stage, who were poorly graded, and had positive peritoneal cytology and tumour recurrence. Patient's age, stage, grade, tumour residue, positive peritoneal cytology, and overall survival rate correlated with p53 accumulation and DNA ploidy. No association of histological subtype with p53 and DNA ploidy was observed. p53 was also strongly related to DNA ploidy. p53 and DNA ploidy were found to be important determinants of recurrence in univariate analyses. Of the factors analysed, p53 was the significantly stronger independent predictor factor for tumour recurrence. Utilizing survival as the endpoint for multivariate analysis, age, grade, tumour residue, and DNA ploidy were independent prognostic indicators. Conclusions: p53 expression and DNA ploidy were related to FIGO stage, grade, peritoneal cytology, tumour recurrence and overall survival. p53 was the stronger independent determinant factor for tumour recurrence, while DNA ploidy was the stronger independent prognostic factor for overall survival. Since DNA ploidy and p53 accumulation were significant factors for overall survival when submitted to univariate and multivariate analysis, they can be useful factors when making a prognosis.

Ovarialkarzinom - p53 - DNA-Ploidie - Prognosefaktoren

Ovarian cancer - p53 - DNA ploidy - prognostic factors

References

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