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PubMedDate not supplied

Immunohistochemical detection of thymidylate synthase in advanced gastric cancer: a prognostic indicator in patients undergoing gastrectomy followed by adjuvant chemotherapy with 5-fluoropyrimidines.

To investigate prognostic indicators for gastric adenocarcinomas in advanced stage, we have carried out immunohistochemical determination of thymidylate synthase (TS) in carcinoma tissues. Sixty seven cases of curatively resected gastric carcinoma, under 70 years old at the time of surgery, who had been in the same grade of invasion and lymph nodal involvements (pT3/pN2, Stage IIIB), and had underwent postoperative 5FU-related chemotherapy for a long period were extracted from the files of our hospital. Formalin-fixed and paraffin-embedded specimens were stained with an antibody for human TS (polyclonal). A positive signal was always compared with some types of inflammatory cells in the same slide because of their constantly strong signal. Normal control tissue used was human bone marrow containing blastic cells. Both staining intensity and the fraction of positively stained carcinoma cells were examined in each case, and then the results were summarized with respect to fraction of positively stained carcinoma cells. The present study indicates that the TS-negative group had better survival than the positive group (p < 0.05), the 5 year survival rates being 42.3% and 25.1%, respectively, which suggests that the frequency of TS-positive carcinoma cells could also be a prognostic indicator.

Antimetabolites, Antineoplastic↗
PubMedDate not supplied

Idiopathic dilated cardiomyopathy in dogs: survival and prognostic indicators.

To further define the prognosis and identify clinical findings predictive for survival in dogs with dilated cardiomyopathy (DCM), we performed Kaplan Meier survival analysis of 37 dogs with idiopathic DCM. Survival analysis showed that the 50% probability of survival occurred at 2.3 months. Probability of survival at 1 year was 37.5% and at 2 years was 28%. Bivariate Cox proportional hazard ratios identified pleural effusion and pulmonary edema, both signs of congestive heart failure, as independent prognostic indicators for dogs with DCM (P < .01). Hazard ratios for these prognostic indicators were 2.354 and 3.291, respectively. Multivariate Cox stepwise regression identified pleural effusion, left ventricular free-wall thickening fraction, ventricular ectopy, and weight loss as significant prognostic indicators for dogs with DCM. Because of the retrospective nature of this study, the effects of different drug treatments were not evaluated. The type of cardiac-related death, progressive failure versus sudden death, was not addressed in this study and requires further evaluation.

Animals↗
PubMed2000

Ovarian serous borderline tumors: a critical review of the literature with emphasis on prognostic indicators.

BACKGROUND: The behavior of ovarian serous borderline tumors (SBTs) and significance of various prognostic factors are unclear and difficult to evaluate because of inconsistencies and confusion in the literature. Recent studies have suggested that the morphological features of the primary tumor (presence or absence of micropapillary features) and the peritoneal "implants" (presence or absence of invasive features) can reliably subclassify SBTs into benign and malignant types. The aim of the current review was to test two hypotheses. First, that the alleged malignant behavior of SBTs is poorly documented, and second, that the morphological features of the primary ovarian tumors and the associated peritoneal implants are sufficient to separate SBTs into benign and malignant types, thereby obviating the need for the category. METHODS: 245 studies reporting approximately 18,000 patients with borderline ovarian tumors were reviewed. After excluding series that lacked clinical follow-up or were not analyzable for other reasons, there remained 97 reports that included 4,129 patients. In addition to recurrences and survival, we evaluated the type of peritoneal implants, microinvasion, lymph node involvement, late recurrences, and progression to carcinoma, as these features have served as the underpinning of the concept of "borderline malignancy" or "low malignant potential." RESULTS: Among 4,129 patients with SBTs reviewed, the recurrence rate after a mean follow-up of 6.7 years was 0.27% per year for stage I tumors, the disease-free survival was 98.2%, and the overall disease-specific survival rate was 99.5%. For patients with advanced-stage tumors, the recurrence rate was 2.4% per year. However, the majority (69%) of reported recurrences were not pathologically documented, and only 26 cases (8.4% of all recurrences) were documented to have recurred from an adequately sampled ovarian tumor. The most reliable prognostic indicator for advanced stage tumors was the type of peritoneal implant. After 7.4 years of follow-up, the survival of patients with noninvasive peritoneal inplants was 95.3%, as compared with 66% for invasive implants (P < .0001). Microinvasion in the primary ovarian tumor was associated with a 100% survival rate at 6.7 years, and lymph node involvement was associated with a 98% survival rate at 6.5 years. The few reported cases of stage IV disease, progression to invasive carcinoma, and very late (>20 years) recurrences were poorly documented. The survival for all stages among approximately 373 patients in 6 prospective randomized trials followed for a mean of 6.7 years was 100%. CONCLUSION: Surgical pathological stage and subclassification of extraovarian disease into invasive and noninvasive implants are the most important prognostic indicators for SBTs. Survival for stage I tumors is virtually 100%. Survival for advanced stage tumors with noninvasive implants is 95.3%, whereas survival for tumors with invasive implants is 66%. Invasive implants behave as carcinomas and are most likely metastatic. The precise nature of so-called noninvasive implants is not clear, but they behave in a benign fashion. The presence of a micropapillary architecture in the primary ovarian tumor is a strong predictor of invasive implants. These data support the recommendation that ovarian tumors with a micropapillary architecture be designated "micropapillary serous carcinomas," and those lacking these features, "atypical proliferative serous tumors."

Cystadenoma, Serous↗
PubMed1996

Prognostic indicators of the outcome of meningococcal disease: a study of 562 patients.

To assess prognostic indicators of a fatal outcome in patients with meningococcal disease, data from 562 patients with culture-proven meningococcal disease, reported in the Netherlands between 1 April 1989 and 30 April 1990, were collected prospectively by means of a questionnaire completed by the specialist in attendance. Analysis was done by the chi2 test and multiple logistic regression. During the study period 43 patients (7.7%) died. The risk of a fatal outcome was increased in patients aged 0-5 months, 10-19 years, and > or = 50 years, in female patients and in patients presenting with coma, temperature < or = 38.0 degrees C, mean arterial pressure < or = 70 mmHg, white blood cell count < or = 10 x 10(9)/L and platelet count < or = 100 x 10(9)/L. Predisposing factors and duration of disease before admission were significantly associated with outcome, but these associations disappeared in the multivariate analysis. Race, the administration of antibiotics prior to admission, seizures and haemorrhagic skin lesions were not associated with outcome. In conclusion age, gender, coma, temperature, mean arterial pressure, white blood cell count and platelet count were independent prognostic indicators of the outcome of meningococcal disease. The assessment of these characteristics may be helpful for the identification of high risk patients, whose prognosis might be improved by prompt transfer to an intensive care unit.

Adolescent↗
PubMed2000

PTP LAR expression compared to prognostic indices in metastatic and non-metastatic breast cancer.

Several prognostic indices in breast cancer, including c-erbB2, epithelial growth factor receptors (EGFR), estrogen and progesterone receptors are signal transduction molecules. Recently, expression of another signal transduction molecule, the protein tyrosine phosphatase LAR, has been suggested to be increased in breast cancer. The objective of the current investigation was to examine the relationship between LAR expression and prognostic parameters in breast cancer. LAR expression was associated with metastatic potential in the well-characterized 13762NF rat mammary adenocarcinoma clones. The metastatic MTLn3 and MTLn2 clones expressed sizable amounts of LAR. The essentially non-metastatic MTC clone had little LAR expression. C-erbB2 had highest expression in the highly metastatic MTLn3 clone, but c-erbB2 levels were sizeable in the weakly metastatic MTLn2 and non-metastatic MTC clone. EGFR expression had the strongest association with a clone's metastatic potential, being very high in MTLn3, weak in MTLn2, and undetectable in MTC. In human breast cancer specimens, LAR expression was strongly positive in 50% of metastatic cases but in only 21% of 'non-metastatic' cases. As with the 13762NF-derived clones, c-erbB2 expression was strongly positive independent of metastatic phenotype. However, 46% (6/13) of cases that were strongly positive for c-erbB2 were strongly positive for LAR. Only 17% (2/11) of negative or weakly c-erbB2 positive samples were strongly positive for LAR. All ER+ positive tumors (n = 15) were positive for LAR and 53% of these tumors were strongly positive for LAR. In ER negative cases, only 1 of 11 was strongly positive for LAR. While the current data indicate a strong association between ER and LAR expression in breast cancer tissue (p = 0.003), additional studies are warranted to further explore the relationship between LAR and prognostic indices of breast cancer progression.

Adenocarcinoma↗
PubMed1978

The lack of correlation of gallium (67Ga) scans with known prognostic indicators in childhood acute lymphocytic leukemia.

67Gallium-citrate scans were performed on 45 patients with acute lymphoblastic leukemia (ALL) at the time of diagnosis. The extent of uptake and distribution of gallium were compared to known prognostic indicators of age, initial white count, and bone marrow lymphoblast immune markers (T, B, and null cell). Selective increased uptake was noted in bone, kidney, liver/spleen, lymph nodes, or other sites in 29 patients, and 16 patients had "normal" scans. A scoring system giving one point for selective uptake in each organ system was used. Patients were grouped according to scores of zero, 1--2, and 3 or greater. There was no significant correlation found between total gallium scores and any of the three prognostic indicators. There was also no significant correlation when prognostic factors were compared to uptake in the individual organ systems except that T cell disease was associated with a significantly greater propensity for lymph node uptake. There was a suggestion that children with "normal" gallium scans may have a better long-term prognosis, since 6 of 7 nonrelapsers observed for longer than 18 months had scores of zero at diagnosis compared to 4 of 6 early deaths with scores greater than zero. This study indicates that the 67Ga scan does not significantly correlate with known prognostic indicators, with the possible exception of lymph node uptake in T cell disease, and its value as an independent indicator of long-term survival will require longer follow-up.

Adolescent↗
PubMed1995

Prognostic indicators in a range of astrocytic tumours: an immunohistochemical study with Ki-67 and p53 antibodies.

The treatment and prognosis of patients with cerebral astrocytic tumours are currently guided by histopathological classification. This study evaluates immunohistochemistry using Ki-67, an antibody to a nuclear protein expressed in proliferating cells, and DO-7, an antibody to the product of the tumour suppressor gene p53, as prognostic indicators for these tumours. Immunohistochemistry with Ki-67 has been correlated with the behaviour of many different tumours, but its value as a prognostic indicator in astrocytic tumours is diminished by the conflicting results of previous studies. Immunohistochemistry with antibodies to the p53 protein has been used as a prognostic indicator in melanomas and some carcinomas, but the relation between prognosis and accumulation of this protein in astrocytic tumours has not been clarified. We have tested the hypothesis that survival is correlated with Ki-67 immunolabelling indices (LIs) and patterns of p53 immunolabelling in the cerebral astrocytic tumours of a large cohort of patients (n = 123) for whom clinical indices were well documented. Astrocytic tumours were divided into three histological types: fibrillary astrocytoma (n = 24), anaplastic astrocytoma (n = 31), and glioblastoma (n = 68). Histological type and patient age were independent predictors of survival. Median Ki-67 LIs differed significantly (P < 0.0001) between the types of astrocytic tumour, and tumours with a Ki-67 LI < 2% had a significantly (P < 0.0001) better prognosis. Ki-67 LI as a continuous variable carried a significant (P = 0.0043) unadjusted hazard to survival which was lost when adjusted for other variables, notably histological type. By contrast, no relation was found between survival and three categories of p53 labeling (p53-negative, p53 LI < 40%, and p53 LI > 60%). The results indicate that, whereas Ki-67 immunohistochemistry predicts survival in patients with astrocytic tumours, conventional histological appraisal remains the best guide to prognosis, and immunohistochemistry for p53 has no value in the assessment of these tumours.

Adult↗
PubMed1999

Markov optical texture parameters as prognostic indicators in ovarian carcinoma.

Texture is a descriptive property of a surface describing the morphometric heterogeneity of complex structures. Computer aided image analysis allows optical texture measurement and analysis of gray-scale images. The authors, utilizing image analysis, prospectively studied Markov nuclear texture features to determine their relevance as prognostic indicators of survival in patients with epithelial ovarian carcinoma. Ninety-nine consecutive patients with ovarian cancer, treated initially with surgery were evaluated for their length of survival, level of cytoreduction, FIGO stage, grade, histology, and DNA index, as well as 20 Markov texture features. Markov nuclear texture features were quantified using image analysis. Mean follow-up for the study population was 64 months (median 59) with a range from 51 to 89 months. Five optical texture features showed significant correlation with length of survival. Difference entropy (P = 0.033) and information measure A (P = 0.041) were both indirectly correlated with survival while information measure B (P = 0.030), correlation coefficient (P = 0.045), and the maximum correlation coefficient (P = 0.041) were directly correlated. Only sum entropy (P = 0.035), FIGO stage (P = 0.0031), and level of cytoreduction (P < 0.0001) were independent predictors of survival in this population. Optical texture can be quantified by image analysis. Utilizing multivariate analysis, the Markov texture feature, sum entropy, was demonstrated to be an independent prognostic indicator of survival in patients with epithelial ovarian cancer. FIGO stage and optimal cytoreduction also were independent prognostic indicators of survival.

Journal Article↗
PubMed2006

Quantitative prognostic indicators of peritoneal dissemination of gastric cancer.

There are three classifications that describe the quantitative prognostic indicators of peritoneal dissemination for gastric cancer. The Japanese classification (P1, P2, and P3, Lyon classification, (stage I, II, stage III, and stage IV), and the Peritoneal Cancer Index (PCI). Carcinomatosis with limited extent (P1/ P2) corresponds to the PCI less than 13 and the stage I and II from Lyon classification. Carcinomatosis with large extent (P3) corresponds to PCI of 13 or larger and stage III and IV from Lyon classification. PCI enables one to describe the precise distribution of peritoneal dissemination. All three classifications correlate with prognosis. With regard to the surgical cytoreduction of the primary tumor and the peritoneal dissemination, Sugarbaker proposed the classification of completeness of cytoreduction (CCR). Patients with no macroscopic residual tumor had significantly better prognosis than those with residual disease. CCR is a valuable prognostic indicator after cytoreductive surgery.

Humans↗
PubMed2003

Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy.

OBJECTIVE: We evaluated the predictive value of several proposed prognostic indicators and the effect of surgical management and adjuvant therapy on clinical outcome associated with leiomyosarcoma (LMS) of the uterus. METHODS: A medical record search of patients treated at Mayo Clinic from 1976 through 1999 was performed using the International Classification of Diseases, Ninth Revision codes for LMS and malignant neoplasm of the uterus. Study inclusion criteria included confirmation of the diagnosis of LMS of the uterus by a pathologist at our institution. Survival curves were generated using the Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazards model. A case-control investigation was also performed. RESULTS: A total of 208 patients met study requirements. The median follow-up for survivors was 7.7 years. Multivariate analysis showed that high grade, advanced stage, and oophorectomy were associated with significantly worse disease-specific survival. Case-control investigations suggested that ovarian preservation does not adversely affect survival and that adjuvant pelvic radiation therapy does not significantly improve survival. An LMS risk-assessment index that was generated is highly predictive of survival. CONCLUSION: Tumor grade and stage (using modified criteria for endometrial cancer) appear to be valid prognostic indicators for LMS of the uterus. Ovarian preservation may be considered in premenopausal patients with early-stage leiomyosarcoma of the uterus. Additionally, adjuvant therapy does not appear to significantly affect survival. Finally, our highly predictive LMS risk-assessment index may be useful for counseling patients.

Adult↗
PubMed1994

Helix pomatia agglutinin binding is a useful prognostic indicator in colorectal carcinoma.

BACKGROUND: Most deaths from colorectal carcinoma are due to metastases. A relatively reliable prognostic indicator at surgery to date is the Dukes' stage, but this is a morphologic approach that does not elucidate biochemical changes to explain why cells became metastatic. The binding sites for the lectin from the Roman snail Helix pomatia (HPA) were shown to be good prognostic indicators in breast and gastric cancer, and accordingly, this study was performed to evaluate the use of HPA binding sites as prognostic markers in colorectal carcinoma. METHODS: The histochemically detected expression of HPA binding sites in colorectal carcinomas (n = 130) was increased. The results of the histochemical findings were correlated with patient survival and tumor recurrence. RESULTS: The results indicated that the prognosis for the groups of patients whose colorectal cancer cells binded to HPA in tissue sections was almost as bad as those with Dukes' Stage C disease. CONCLUSION: Because HPA binds to N-acetylgalactosamine, the authors' results indicate that this sugar residue is at least partly involved in the process of human colorectal carcinoma cells metastasizing to regional lymph nodes and possibly also to distant sites.

Acetylgalactosamine↗
PubMed1999

p53 expression as a prognostic indicator of 5-year survival in endometrial cancer.

BACKGROUND: One of the most common genetic alterations to occur in human cancers is an alteration of the p53 tumor suppressor gene. The purpose of this article was to build upon the authors' previous work with p53 and determine whether p53 was a prognostic indicator of 5-year survival. METHODS: One hundred thirty-seven consecutively surgically treated patients with endometrial cancer had their p53 expression studied by immunoperoxidase staining and quantified by image analysis. All patients were evaluable for 5-year survival. RESULTS: One hundred three patients had endometrioid adenocarcinoma; 6, adenosquamous carcinoma; 14, papillary serous carcinoma; 10, clear cell carcinoma; and 4, undifferentiated carcinoma. p53 expression ranged from 0.0 to 58.2% positive nuclear area with a mean of 11.5% (median 2.6%) for the cohort. For the patients with endometrioid carcinoma, the mean p53 expression was 7.1% while for the nonendometrioid tumors it was 24.6% (P<0.001). Fifty-nine of the 103 endometrioid tumors (57.3%) stained positive for p53 while 32 of the 34 nonendometrioid (94.1%) tumors stained positive (P<0.001). Increasing histologic grade correlated with an increasing p53 expression (P = 0.003). The percentage of tumors expressing p53 was found to be higher in FIGO stage II, III, and IV than in FIGO stage I cancer (P = 0.003). However, mean p53 expression did not differ between early (stage I) and advanced (stage II, III, and IV) cancers (P = 0.088). Utilizing 5-year survival as the endpoint for multivariate analysis, FIGO stage (P = 0.0028) and p53 expression (P<0.001) were the only independent prognostic indicators found. CONCLUSION: p53 expression is more commonly found in nonendometrioid than in endometrioid adenocarcinoma of the endometrium. It, along with FIGO stage, is an independent prognostic indicator of 5-year survival.

Adult↗
PubMed2000

Prognostic indicators of successful endoscopic sclerotherapy for prevention of rebleeding from oesophageal varices in cirrhosis: a long-term cohort study.

BACKGROUND: Although band ligation is now recommended for prevention of rebleeding from oesophageal varices in cirrhosis, sclerotherapy is still widely used. Patients submitted to chronic sclerotherapy undergo several endoscopies and experience a large number of serious complications. However, long-term outcome is poorly defined. AIMS: To assess the clinical course and prognostic indicators of patients undergoing chronic sclerotherapy for prevention of variceal rebleeding as a basis for future evaluation of long-term band ligation outcome. METHODS: Prospective cohort study; prognostic analysis by the Cox proportional hazards model. RESULTS: A total of 218 consecutive cirrhotic patients (37 Child class A, 154 B, 27 C) were enrolled in the study Varices were obliterated in 139 (64%) patients in a mean of 5 (+/-2.6) sessions and recurred in 58/139 (41.7%) within one year. A total of 132 (60%) patients experienced 283 rebleeding episodes and 73 (33%) died. Bleeding from oesophageal ulcers was the most serious complication causing 14% of all rebleeding episodes. Significant prognostic indicators of sclerotherapy outcome were: Child-Pugh class for variceal obliteration; gastric varices and platelet count for recurrence of varices; failure to obliterate varices, variceal size and gastric varices for rebleeding; blood urea nitrogen and failure to obliterate varices for death. Presence of gastric varices was the only prognostic indicator for death in the 79 patients not achieving variceal obliteration. A mean of 10 endoscopies and of 6 hospital admissions were needed per each patient with an estimated cost of US dollars 7154 per patient during the first two years of therapy. CONCLUSIONS: Sclerotherapy is a very demanding and costly treatment, and is associated with frequent and serious side-effects. The probability of treatment failure is significantly higher in Child C patients with gastric varices. Alternative treatments should be considered for these patients.

Aged↗
PubMed1983

Malignant peritoneal cytology as prognostic indicator in stage I endometrial cancer.

The prognostic significance of malignant peritoneal cytology was evaluated in 93 patients with stage I endometrial cancer seen at Roswell Park Memorial Institute. Eighty-three patients (89%) had negative cytologic samples and ten (11%) had positive cytology for neoplastic cells. All patients were followed for a minimum of ten years or until dead from cancer or intercurrent disease. No patient received treatment for positive cytology. There was one recurrence in the patients with positive cytology (10%), and six recurrences in the negative group (7%). The actuarial survival rate at five and ten years for patients with negative cytology was 93.9 and 92.5%, respectively. For patients with positive cytology, the survival was 87.5% at both time intervals. No significant difference was found between the groups. Malignant peritoneal cytology does not seem to be a prognostic indicator in stage I endometrial cancer.

Actuarial Analysis↗
PubMed1991

Retrospective application of prognostic indices to pancreatitis discovered at necropsy.

Six prognostic indices, which were developed to assess inpatients with acute pancreatitis, were evaluated for possible retrospective application. When applied to a series of 14 cases in whom pancreatitis was first diagnosed at necropsy, the index devised by Jacobs et al was found to be the most useful, because in nine of these cases eight or more of the variables required were available for assessment from the case records. In the other indices evaluated fewer than eight of the required variables were available for retrospective assessment in most cases. Although undiagnosed pancreatitis is probably uncommon as a sole cause of death, the retrospective use of one or more of these indices may help assess the severity of the patient's condition on admission to hospital.

Acute Disease↗
PubMed1990

Is DNA ploidy an independent prognostic indicator in infiltrative node-negative breast adenocarcinoma?

To evaluate DNA content as an independent, long-term prognostic indicator in infiltrative, node-negative adenocarcinoma of the breast, flow cytometric DNA analyses were performed retrospectively in 165 patients. The exclusive use of paraffin-embedded tissue permitted the study of patients for whom 3 to 15 years' follow-up was available. Other investigators have shown a relationship between DNA nuclear content and well-known prognostic indicators of breast carcinoma, such as estrogen receptors, age, menopausal status, and stage of tumor. However, very few of these studies were based on patients with long-term clinical follow-up and investigated the independent prognostic value of DNA nuclear content. The frequency of aneuploidy in the patients in this study was 57%, with DNA indices ranging from 0.73 to 2.59. Survival in patients with localized breast carcinoma with DNA aneuploid tumors was 84.1% at 5 years and 75.5% at 10 years. Those with diploid tumors showed survival of 87.8% at 5 years and 73.4% at 10 years. These data show no independent prognostic value for DNA nuclear content. The relationship between DNA content, tumor histologic type, and age was also investigated. High-grade tumors were more often aneuploid. There was no association between DNA content and age. Of 165 patients, information regarding estrogen receptor status was available in only 77; 45% of those with aneuploid tumors and 35% with diploid tumors were estrogen receptor-negative. This difference was not significant. The authors conclude that simple determination of DNA ploidy fails to indicate prognosis for infiltrative, node-negative breast carcinoma.

Adenocarcinoma↗
PubMed1985

Prognostic indicators in the psychotherapy of borderline patients.

Although diagnostic and therapeutic difficulties, including countertransference problems, in borderline patients make prognostic estimates hazardous, practical necessity often requires a prognostic judgment regarding treatability. This paper proposes a list of prognostic indicators in borderline patients which may be useful to the psychotherapist in the evaluation of treatability. Unfavorable prognostic indicators include history of brutalized early environment, severe behavior problems in childhood, antisocial behavior, addictions, egosyntonicity, superficial or highly disturbed relationships, marked narcissistic features, injurious social environment; and, in the course of therapy, strong negative reaction of the therapist toward the patient, and antisocial acting out. Suggesting a more favorable prognosis for psychotherapy are: nonspecific personality traits which may promote the therapeutic relationship (likeableness, warmth, reliability, or interest in people), and intact sublimatory outlets (talents, skills). In general, the quality of object relations, especially the therapist-patient relationship, including the countertransference, is crucial to prognosis. The unfavorable prognostic implications of certain atypical forms of anxiety, depression, and dependency, as well as anhedonia and abulia, are discussed. Borderline patients with infantile features probably have better prognosis than is generally recognized; with narcissistic features, a worse prognosis than generally recognized.

Adult↗
PubMed1999

p53 staining as a prognostic indicator in endometrial carcinoma.

OBJECTIVE: To investigate p53 expression in endometrial cancer and its significance as a prognostic indicator. METHODS: Thirty-five consecutively surgically treated patients with endometrial cancer had their p53 expression studied by immunoperoxidase staining and quantified by lighted microscopic evaluation of the staining pattern. The determination of mean percentage of p53 expression was compared to prognostic indicators of endometrial cancer. RESULTS: p53 staining was detected in 20 of the 35 cases of endometrial carcinoma. Eleven of the 21 endometrioid tumors stained positive, while 9 out of 14 tumors with more aggressive histology stained positive for p53. If the grade I and II patients were taken into account as a whole, there was a statistically significant correlation (p<0.001) between the grade I and II patients and the grade III patients. The difference was statistically significant between stage I and III (p<0.05). The difference between lymphovascular space invasion and no lymphovascular invasion and p53 positivity was statistically significant (p<0.05). CONCLUSION: p53 expression is more common in more aggressive histologic subtypes than in endometrioid adenocarcinomas. Strong expression of p53 correlates with advanced stage and high grade and is detected more frequently in endometrial cancers with lymphovascular invasion.

Adenocarcinoma↗