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유방암에서 p53 단백 과발현과 기존의 예후인자들과의 상관성에 관한 연구
전훈배,구범환 고려대학교 의과대학 1995 고려대 의대 잡지 Vol.32 No.1
Reliable prognostic markers are meeded in treast cancer management to help clinicians identify the patients with the high risk of recurence and arrive at more rational decisions for treatment. The nuclear phosphoprotein p53 is faintly esxpressed in all normal cells and appears to function in suppressive regulation of cell cycle. Abnormally high levels of p53 protein are found in many different tyupes of cancer. To evaluate prognostic significance of p53 mutation, the author analyzed the association between nuclear overexpression of p53 protein on immunohistochemical stain of archival paraffin embedded tissue and following established prognostic parameters of 49 breast cancer patients operated between september 1987 and August 1991 in Korea University Hospital: Tumor size, axillary node involvement, menopausal status, estrogen receptor status, progesterone receptor status. DNA ploidy, and histological grade. Imrnunohistochemical stain of p53 protein was also perfomed on ten cases of fibroadenoma for negative control. Twenty four(49%) cases showed overexpression of p53 protein in immunohistohemical stain of archival paraffin embedded tissue and following established prognostic parameters of 49 breast cancer patients operated between september 1987 and August 1991 in Korea University Hospital: tumor size, axillary node involvement, menopausal status, estrogen receptor status, progesterone receptor status, DNA ploidy, and histological grade, Immunohistochemical stain of p53 protein was also perfomed on ten cases of fibroadenoma for negative control. Twenty four(49%) cases showed overexpression of p53 protein in immune-histochemical staining using two murine anitihuman p53 protein monoclonal antibodies(NCL-P53-DO7&NCL-p53-240, Novocastra Lab., U.K.). Although associations were found between p53 overexpression and large tumor size, negativity of estrogen receptor, and negativity of progesterone receptor, a high statistical significance was found only between p53 overexpression and negativity of estrogen receptor (P<0.01). In 47 cases which had been followed up for more than 36 months(median 50 months), the overall survival showed no statistically significant difference between two groups of patients with of without p53 overexpression. But the p53 overexpression was found to be significantly associated with the shorter relapse-free survival of patient (P<0.02). When combined with estrogen receptor status, the overexpression of p53 protein may have a more significant role in prediction of prognosis. At a result of this study, it is concluded that the p53 gene mutation can be considered as a useful prognostic marker for breast cancer patients, and more aggressive therapeutic approach is warranted to such group of patiens with p53 gene mutation.