QUANTIFICATION OF P53 IN EPITHELIAL OVARIAN-CANCER

Objective. The perceived function of wild-type p53 is suppression of c ell proliferation. An alteration in the p53 tumor suppressor gene is a common defect in human malignancies. The purpose of this study was to prospectively determine whether p53 expression, as quantified by imag e analysis, was related to traditional prognostic indicators as well a s survival in patients epithelial ovarian cancer. Methods. Eighty-thre e consecutive patients with epithelial ovarian cancer had their p53 ex pression studied by immunohistochemical staining and quantified by ima ge analysis. Unless otherwise noted, p53 expression was reported as th e percentage positive nuclear area staining. Results. The mean follow- up was 37 months (median, 30 months; range 24-55 months). In patients with serous carcinomas of the ovary, the mean p53 expression was 29.4% , whereas in patients with other histologies, the mean was 10.5% (P < 0.001). The tumors of patients with stage III or IV tumors stained sig nificantly higher (mean 28.7%) than the tumors of patients with stage I or II disease (mean 8.36%) (P < 0.001). The tumors of patients with disease which could be optimally cytoreduced stained significantly low er (mean 23.0%) than the tumors of patients whose disease was unable t o be optimally cytoreduced (mean 28.6%) (P = 0.041). Utilizing surviva l as the endpoint for multivariate analysis, FIGO stage (P = 0.006), p 53 expression (P = 0.046), and the level of cytoreduction (P < 0.001) were independent prognostic indicators. Conclusion. Image analysis all ows quantitative measurements of p53 staining. p53 staining is signifi cantly higher in advanced-stage, high-grade tumors which are unable to be cytoreduced than in early-stage, low-grade tumors which can be opt imally cytoreduced. p53 expression is an independent prognostic indica tor of survival in patients with epithelial ovarian carcinomas. (C) 19 97 Academic Press.