국소적 식도암의 복합치료 시 예후 인자로서 p53단백과 발현이 완전 반응과 생존에 미치는 영향
The Prognostic Significance of the p53 Overexpression on Complete Response and Survival in Preoperative Chemoradiotherapy Treated Squamous Cell Esophageal Carcinoma
대한암학회지 1998년 30권 2호 p.278 ~ 287
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김성배
김상희/정훈용/이헌경/강경훈/김종훈/송호영/박승일/김동관
KMID : 0360319980300020278
Abstract
결론
복합 치료를 시행한 국소적 식도암 환자 42예 중 27예에서 p53 단백 과발현을 보여 p53
단백 과발현율은 64.2%였으며, P53 단백 비발현일 경우 p53 단백 과발현군에 비해 조직학
적 완전 반응 획득율이 비교적 높고, 생존기간의 연장 및 질병 무진행성 생존기간
(progression free duration)의 증가경향을 보이나, 통계적인 유의한 차이는 없었다. 향후 더
많은 국소적 식도암 내시경 생검 조직에서 p53유전자 변이에 대한 검색을 통해 식도암에서
p53유전자의 역할을 규명할 수 있을 것으로 사료된다.
Purpose : To determine the frequency of p53 overexpression and to analyse the
relationship between p53 overexpression and complete response rate, survival in
locoregionl squamous cell esophageal cancers treated with preoperative chemoradiation
multimodality approaches.
Materials and Methods : Using a microwave oven heating method, we have detected
p53 overexpression by immunohistochemically with a monoclonal antibody(DO-7) in
formalin-fixed paraffin-embedded samples of 42 patients with locoregional squamous cell
esophageal cancer, who treated with concurrent chemotherapy and radiation followed by
surgery.
Results : In 27 of 42 tumors(64.2%), nuclear immunoreactivity for the p53 protein was
detected. Complete response rate, evaluated in surgical specimen 3-4 weeks after
chromo-radiation seemed to be high in p53 positive group compared to p53 negative
group, however, there was no statistically significant difference in acquiring better
complete response rate, overall survival and progression free survival between p53
positive and p53 negative group(p=0.0546, p=0.0599, p=0.6832). Complete response
group(n=17) survived longer than non-complete response group(n=25)(p=0.0010).
Conclusion : The results indicate that p53 is not a statistically significant prognostic
factor in obtaining better complete response rate, overall survival and progression free
survival of the patients with esophageal carcinoma treated with preoperative
chemoradiotherapy. Additional studies are warranted for further evaluation.
키워드
p53 overexpression; Esophageal cancer; Immunohistochemistry; Prognostic factor;
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