THE COMBINED EVALUATION OF P53 ACCUMULATION AND OF KI-67 (MIB1) LABELING INDEX PROVIDES INDEPENDENT INFORMATION ON OVERALL SURVIVAL OF OVARIAN-CARCINOMA PATIENTS

Background: The prognostic implications of p53 accumulation, bcl-2 imm unoreactivity and tumour proliferative fraction in ovarian carcinomas are still debated. Patients and methods: One hundred twelve ovarian ca rcinomas were immunostained for p53 protein? for bcl-2 and for the cel l cycle-associated Ki-67 antigen. The immunostaining results were corr elated with conventional clinico-pathological variables, response to i nduction chemotherapy, and patient survival. Results: p53 accumulation and bcl-2 immunoreactivity in more than 10% of neoplastic cells were detected in 61 (54.5%) and 42 (37.5%) cases, respectively A positive c orrelation between p53 accumulation and high (more than 30% neoplastic cells) MIB1 labelling index (r = 0.235; P = 0.015) was ascerrained, w hereas no significant association was found between bcl-2 immunoreacti vity and p53 accumulation or MIB1 labeling index. Both p53 accumulatio n and MIBI immunoreactivity correlated significantly with a reduced ov erall survival, but the association was lost in multivariate analysis. However, patients with tumours simultaneously showing p53 accumulatio n and MIB1 labelling index higher than 30% had significantly reduced o verall survivals, in both univariate and multivariate analyses. Conclu sion: The simultaneous evaluation of p53 accumulation and MIBI labelli ng index has independent prognostic implications in common epithelial malignancies of the ovary, irrespective of the disease stage.