PROGNOSTIC VALUE OF P53 AND PROLIFERATING CELL NUCLEAR ANTIGEN EXPRESSION IN ENDOMETRIAL CARCINOMA

The degree of expression of p53 acid proliferating cell nuclear antige n (PCNA) was measured in archival samples from 221 patients managed su rgically for endometrial carcinoma between 1979 and 1983. With use of primary antibodies to the p53 protein (DO7) and PCNA (PC10), immunoper oxidase nuclear staining of paraffin-embedded tissue was performed. Th e computerized CAS200 Image Analysis System was used to determine the percentage of nuclear area stained. There was no evidence to conclude that progression-free survival differed with respect to PCNA expressio n. In contrast, intense p53 expression (66% or more nuclear area stain ed) was significantly associated with compromised progression-free sur vival both in the analysis of all stages (P < 0.001) and in the subset of patients with stage I disease (P < 0.001). Intense expression of p 53 was significantly associated with other prognostic indicators, incl uding stage, grade, depth of myometrial invasion, histologic subtype, cytologic findings, DNA ploidy, and HER-2/neu expression. Multivariate analysis identified four independent prognostic factors for progressi on-free survival in endometrial carcinoma: intense p53 expression, his tologic subtype, DNA ploidy status, and HER-2/neu expression. When non e of these four independent factors are present, the 4-year progressio n-free survival is 96%. In contrast, it is 63% when one or more of the se factors are present (P < 0.001) and 40% when two or more factors ar e present (P < 0.001). (C) 1996 Academic Press, Inc.