P53表达对晚期上皮性卵巢癌一线化疗方案选择的意义  

Predictive Value of P53 Expression in Selecting First-line Chemotherapy Regimen for Advanced Epithelial Ovarian Carcinoma

作　　者：赵晓东[1] 张毅[1] 何淑蓉[2] 杨丽[2] 

机构地区：[1]北京医院妇产科,北京100730 [2]北京医院病理科,北京100730

出　　处：《癌症》2005年第12期1542-1545,共4页Chinese Journal of Cancer

摘　　要：背景与目的:目前,上皮性卵巢癌的术后一线化疗方案主要包括铂类联合紫杉醇(TC)和铂类联合环磷酰胺(PC)。本研究拟观察分子标记物P53表达与上述两种化疗方案疗效的关系,分析P53表达在化疗疗效预测上的价值,探讨检测P53表达在选择化疗方案上的意义。方法:回顾性分析53例以TC或PC作为术后一线化疗方案的Ⅲc期上皮性卵巢癌,用免疫组化方法检测标本的P53表达,比较P53阳性组和P53阴性组中各化疗方案的完全缓解(completeresponse,CR)率和无进展生存时间(progression-freesurvival,PFS),并行多因素分析影响PFS的预后因素。结果:53例患者中22例P53阳性,其中13例采用TC方案,CR10例(76.9%),中位PFS102周;9例采用PC方案,CR3例(33.3%),中位PFS43周。TC组CR率稍高于PC组(P=0.05),TC组患者PFS长于PC组(P=0.04)。对31例P53阴性患者采用不同化疗方案治疗的CR率和PFS无显著性差异(P>0.05)。多因素分析提示残留病灶大小是独立预后因素。结论:检测P53表达在选择化疗方案上可能有意义。对于P53阳性患者首选TC方案,对于P53阴性患者可以选择PC或TC方案。确切结论尚需进一步在大样本前瞻性研究中验证。BACKGROUND ＆ OBJECTIVE： The first-line adjuvant chemotherapy regimens of ovarian cancer mainly include TC （paclitaxel combined with carboplatin） and PC （cisplatin combined with cyclophosphamide） protocols. This study was to investigate the correlation of P53 expression to treatment outcome of ovarian cancer patients received the above 2 protocols, and explore the predictive value of P53 expression in selecting chemotherapy regimen. METHODS： Records of 53 patients with advanced epithelial ovarian cancer （stage Ⅲc）, treated with TC or PC regimen, were analyzed retrospectively. The expression of P53 was detected by immunohistochemistry. The complete response （CR） rate and progression-free survival （PFS） were compared between TC and PC groups according to P53 status. RESULTS： Of the 53 patients, 22 were P53 positive, of which 13 received TC regimen and 9 received PC regimen; the CR rate was slightly higher in TC group than in PC group （76.9% vs. 33.3%, P=0.054）, and PFS was significantly longer in TC group than in PC group （102 weeks vs. 43 weeks, P=0.040）. In the subgroup of P53-negative patients, TC group had similar CR rate and PFS to PC group. Multivariate analysis showed that the size of residue was an independent prognostic factor. CONCLUSIONS： P53 detection may play a role in selecting first-line chemotherapy for advanced epithelial ovarian cancer patients. TC regimen is preference for P53-positive patients, PC regimen may be a choice for P53-negative patients. These recommendations should be tested in further trails with large samples.

关 键 词：卵巢肿瘤 药物疗法 联合 P53 预测疗效 方案选择 

分 类 号：R737.31[医药卫生—肿瘤]