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Prognostic Significance of Immunohistochemical Expression of p53 and Retinoblastoma Gene Protein (pRB) in Curatively Resected Gastric Cancer

Song, Hong Suk    (Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.   ); Kim, In Ho    (Department of General Surgery, Keimyung University School of Medicine, Daegu, Korea.   ); Sohn, Soo Sang    (Department of General Surgery, Keimyung University School of Medicine, Daegu, Korea.   ); Kwon, Kun Young    (Department of Pathology, Keimyung University School of Medicine, Daegu, Korea.   ); Lee, Won Sik    (Department of Internal Medicine, Fatima Hospital, Daegu, Korea.  );
  • 초록

    Background The aim of this study was to determine the prognostic significance of the expression of p 53 and retinoblastoma (Rb) gene products in cases of curatively resected gastric adenocarcinoma, by immunohistochemical analysis. Methods Between January 1996 and December 2001, 736 curatively resected gastric cancer patients underwent immunohistochemical staining for p 53 or Rb proteins (pRb), and we retrospectively analyzed the correlation of our results with the clinical outcomes of these cases. Results High levels of expression of p 53 (>25% p 53-positive cells) and Rb (>50% Rb-positive cells) proteins were detected in 40.1% and 43.7% of cases, respectively. Tubular type was found to frequently exhibit higher levels of p 53 expression (high expression in 44.2%) than signet ring cell type (high expression in 26.0%) ( p = 0.042). The incidence of vascular invasion was lower in the high pRb expressors (43.2%) than in the pRb low expressors (56.8%), but this was not a statistically significant discrepancy ( p = 0.063). Preoperative CEA levels were found to be low in high pRb expressors: initial CEA level in the high pRb expressors was 2.31±3.30 ng/mL, and was 5.18±24.80 ng/mL in the low pRb expressors ( p = 0.033). Tumor depth and node metastasis were both independent of the levels of expression of p 53 and Rb proteins. The seven-year overall survival rate and relapse-free survival rates of patients were 87.2% and 75.7%, respectively. Multivariate Cox regression analysis indicated that tumor stage, tumor size, patient age and pRb expression were the significant prognostic factors with regard to overall survival, and tumor stage and age were both significant factors with regard to relapse-free survival. Conclusion Immunohistochemical staining of retinoblastoma gene products was an independent prognostic factor for the prediction of overall survival in curatively resected gastric cancer patients.


  • 주제어

    Gastric cancer .   Prognosis .   p53 .   Rb gene .   Immunohistochemistry.  

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