진행성 위암의 예후인자로서 p53, c-erbB-2, nm23, Ki-67 발현의 의의

Abstract

PURPOSE: We investigated the prognostic impacts of p53, c-erbB-2, nm23 and Ki-67 expression in patients with stage II and IIIA gastric carcinoma who underwent curative (RO) resections. MATERIALS AND METHODS: 261 paraffin-embedded gastric carcinoma tissues (stage II, 121; stage IIIA, 135) were stained with the monoclonal antibodies, p53, c-erbB-2, nm23 and Ki-67 using the labelled streptovidin biotin method. The positivity was determined by two pathologists who were kept blind for the patients outcome. RESULTS: The overexpression was seen in 51.7% for p53, 11.9% for c-erbB-2, and 70.1% for nm23. The mean Ki-67 labelling index was 25.5+ 16.7. The rates of overexpression between the stage II and stage IIIA were not significantly different in all these molecules. Overexpression of p53 was more likely to be associated with old age and lymph node metastasis. Overexpression of c-erbB-2 was more likely to be associated with Borrmann type I, II and well-differentiated tumor. However, nm23 was more frequently expressed in patients with older age and well-differentiated tumor. In survival analysis, the overexpressions of p53 and Ki-67 were significantly associated with poor prognosis of the patients (p<0.01), but c-erbB-2 and nm23 were not related to the patients outcome. In a multivariate analysis of prognostic factors, only. the lymph node metastasis was an independent prognostic factor. CONCLUSION: Although the values did not reach statistical significance in a multivariate analysis, the overexpression of p53 and Ki-67 tended to have adverse effects an the prognosis of patients with gastric cancer.