卵巢浆液性癌两级组织学分级系统的评估及p53蛋白过表达的意义

目的 评估卵巢浆液性癌的M.D.Anderson肿瘤中心(MDACC)的两级组织学分级系统在临床诊断和预后判断中的可行性和有效性,并与WHO组织学分级系统进行比较,同时探讨p53蛋白对卵巢浆液性癌分级的辅助作用及其在预后与治疗中的意义.方法 对72例卵巢浆液性癌患者病理资料进行MDACC两级分级和WHO分级,将分级结果与临床指标进行统计学分析.用免疫组织化学EnVision法检测p53蛋白在肿瘤组织中的表达水平,分析其与组织学分级及临床指标的相关性.结果 MDACC分级与WHO分级显示出较好的相关性(r=0.534,P=0.000).虽然两种分级方法均未与无病生存期(P=0.170和0.075)、肿瘤细胞减灭术(P=0.478和0.120)及以铂类为基础的初次化疗效果(P=0.418和0.403)显示出明确的相关性,但与WHO分级相比,MDACC分级与肿瘤分期(P=0.041和0.002)、3年无病生存率(P=0.077和0.004)、总生存期(P=0.080和0.046)和p53免疫组织化学染色结果(P=0.334和0.035)具有更好的显著性相关.此外,p53免疫组织化学染色结果与其他各项临床指标之间未显示出显著的相关性.结论 MDACC分级较WHO分级系统能更好地提示预后,比较符合最新的卵巢浆液性癌不同通路发病学说,临床应用前景良好,但仍需完善和进一步检验.单纯的p53免疫组织化学染色结果有助于辅助卵巢浆液性癌的MDACC分级,但对于判断预后的价值有限,需慎重使用.     

p53 Protein expression in laryngeal squamous cell carcinomas bearing wild-type and mutated p53 gene

We performed an immunohistochemical analysis to investigate the expression of p53 protein in a panel of 18 laryngeal squamous cell carcinomas, 15 primary tumours and three in relapse, previously analysed by us for the presence of p53 gene mutations. Dysplastic and/or normal surrounding mucosa was evaluated in 15 different tumours. The results of our study are the following: (1) expression of p53 protein was observed in one out of five tumours positive for p53 gene mutations (20%) and in 10 out of 13 (80%) negative cases; (2), p53 protein over-expression was frequently observed in normal and/or dysplastic mucosa surrounding either wild-type (7/11) or mutated p53 tumours (2/4); (3), p53 immunoreactive cells showed a pattern of distribution in normal and mildly/moderately dysplastic mucosa (basal layers), different from that in severely dysplastic mucosa (whole thickness). These data further support the hypothesis that p53 protein over-expression may be a marker of the earliest phases of multistep tumorigenesis in laryngeal squamous cell carcinoma.     

Immunolocalisation of heat shock protein 72 and glycoprotein 96 in colonic adenocarcinoma

Heat shock protein 72 (HSP72) and glycoprotein 96 (gp96) are highly expressed in cancer tissues. Recent studies indicate the possible roles of HSP72 and gp96 in the development and progression of colonic carcinomas, but detailed information is still ambiguous. In this study, we investigated the correlation between clinical pathology and immunolocalisation of HSP72 and gp96 in human colonic carcinoma. The distribution of HSP72 and gp96 was studied in 160 human colonic carcinomas, with or without metastasis, as well as in mucous membranes adjacent to cancers by means of immunohistochemistry. HSP72 immunoreactivity was detected in 145 of 160 primary tumours (90.6%) and in 44 of 160 mucous membranes adjacent to cancers (27.5%). Gp96 was detected in 81.3% colonic carcinomas and in 13.8% mucous membranes adjacent to cancer. Immunolocalisation of HSP72 and gp96 was mainly cytoplasmic. HSP72 and gp96 immunolabelling was significantly higher in colonic carcinomas with metastasis than in those without metastasis (P<0.05). The results indicate a significant correlation between the immunopositivity of HSP72 and gp96 and the progression of colonic carcinomas. Immunolabelling of HSP72 and gp96 may be useful as diagnostic or prognostic markers in colonic carcinoma.     

Retinoblastoma and p53 gene product expression in breast carcinoma: Immunohistochemical analysis and clinicopathologic correlation

We examined 100 breast cancers for retinoblastoma (Rb) and p53 protein expression by immunohistochemistry using the PMG3.245 and PAb 1801 antibodies. We assessed percentages of reactive cells and their intensity, as well as staining patterns. The results were correlated with neu protein reactivity and a panel of variables, including age, tumor size and type, nuclear grade, estrogen receptor/progesterone receptor content, and lymph node status. Retinoblastoma protein negativity, either partial or complete, was noted in 47% of cases. Surprisingly, a relatively stronger Rb reaction was seen in some high nuclear grade tumors. p53 positivity was found in 23% of cases and was a significant predictor of Rb loss. p53 also was correlated with poorly differentiated (nuclear grade III) neoplasms and neu expression but not with negative ER status. Tissue distribution profiles for Rb-negative and p53-positive cells were variable in this series, with both uniform and heterogeneous patterns observed. This suggests that Rb and p53 alterations may represent early or late events in transformation. Our findings further implicate Rb and p53 derangements in mammary oncogenesis.     

Immunohistochemical localisation of the 25 kDa heat shock protein in unstressed rats: Possible functional implications

The distribution of the 25 kDa heat shock protein (hsp 25) in a number of tissue types from unstressed rats was investigated. Immunohistochemical analysis showed that hsp 25 was not found in the thymus, brain (cerebral cortex and cerebellum), testis, adrenal, liver, spleen, or kidney. A number of cells in the anterior pituitary showed strong staining. These cells were tentatively identified as being either gonadotropes or thyrotropes. Strong staining was also observed in the blood vessels within these tissues. Hsp 25 was found to be localised predominantly to intestinal smooth muscle of the duodenum and colon and to vascular smooth muscle. Smooth muscle from other sites, such as the trachea, was also intensely stained. Lower and more variable amounts of staining were observed in cardiac and skeletal muscle. These observations suggest that hsp 25 is associated with cytoskeletal elements in muscle, and that the high staining intensity in smooth muscle might be due to the lack of internal architecture present in this muscle type. © 1993 Wiley-Liss, Inc.     

Correlation of p53 protein expression with gene mutation in gall-bladder carcinomas

The correlation of p53 protein expression and p53 mutation of 33 gall-bladder carclnomas was studied accordlng to the depth of invasion and grade of cytological atypia. Overexpresslon of p53 protein was detected by immunostaining in seven (70.00/) of 10 intramucosal and in 16 (69.6%) of 23 invasive carcinomas. p53 mutation was detected in five (71.4%) of the seven intramucosal carcinomas with overexpresslon and In eight (50.0%) of the 16 invasive cancers with overexpression and in one (10%) of the 10 non-overexpressing carclnomas at exons 5–8 by nested polymerase chain reactlon-single-strand conformatlon polymorphism. The overexpression of p53 protein was present In nine (56.3%) of 16 low-grade carcinomas and In 14 (82.3%) of 17 high-grade carcinomas. In cases of overexpresslon, p53 mutatlon was detectable in four (44.4%) of nlne lowgrade and in nlne (64.3%) of 14 high-grade carclnomas. In total, p53 mutation was verified In 56.5%0 (13123) of cases involving protein overexpression and in 10% (1/10) of cases of nonoverexpresslon. The sensltivity of p53 mutation was 56.5% (13/23), the specificity was 90.0% (9/10) and the validity was 1.47. in conclusion, our study indicates that p53 protein overexpression correlates well wlth gene mutatlon and that p53 alteration may be related to increaslng grade of cytologic atypla of carclnomas.     

Immunohistochemical expression of latent membrane protein 1 (LMP1) and p53 in nasopharyngeal carcinoma: Moroccan experience

Background

Nasopharyngeal carcinoma (NPC) is a malignant epithelial tumor intimately associated with Epstein-Barr virus (EBV). NPC is a characteristic tumor displaying epidemiological, genetic and regional distribution properties that makes it unique by its natural behavior.

Objectives

To assess the expression pattern of LMP1 and p53 proteins in the different histological types of NPC in a sample of the Moroccan population and to define any association between the expression of those proteins with the sex, the age and the histological types of NPC.

Methods

Archival formalin-fixed, paraffin-embedded NPC biopsies were evaluated in 23 Moroccan patients for the presence of LMP1 and p53 using immunohistochemistry (IHC).

Results

No LMP1 expression was observed whereas 8 of 23 cases (34. 7%) had detectable p53 protein in the nuclei of tumor cells. After statistical analysis according to the Fisher''s exact probability test, no significant association between p53 expression and histological type, age and sex distributions was demonstrated (p>0.05).

Conclusion

This study confirms that p53 overexpression is present in a subset of Moroccan NPC patients. Our results are consistent with those reported by other studies concerning the same NPC endemic risk area and provide original data concerning Morocco.     

p53和nm23蛋白表达与大肠癌浸润转移的关系

目的：探讨大肠癌组织中ｐ５３和ｎｍ２３蛋白表达与癌组织分化浸润转移的关系,以及它们之间的相关性。方法：应用免疫组织化学（ＳＡＢＣ）方法对４１例大肠癌组织中ｐ５３和ｎｍ２３蛋白表达情况进行检测。结果：大肠癌组织中ｐ５３和ｎｍ２３蛋白表达的阳性率分别为５８．５％和５３．７％,ｐ５３过表达、ｎｍ５３低表达与大肠癌浸润深度和淋巴转移具有相关性,ｐ５３过表达在低分化腺癌中明显高于高分化腺癌（Ｐ〈０．０１）;而ｎｍ２３高表达与大肠癌的分化程度无关（Ｐ〉０．０５）。ｎｍ２３低表达与ｐ５３高表达有相关性。结论：ｐ５３高表达、ｎｍ２３低表达在大肠癌的浸润转移中起重要作用,ｐ５３高表达与大肠癌组织分化程度有关,大肠癌组织浸润与淋巴转移可能与多基因异常改变有关。     

Immunohistochemical analysis of bcl-2 and p53 expression in breast carcinomas: their correlation with Ki-67 growth fraction

We examined 59 breast cancers for p53 and bcl-2 protein expression by immunohistochemistry. The results were correlated with Ki-67 immunostaining. p53-negativity was noted in 40 cases and the remaining 19 tumours were p53-positive. Thirty-six tumours showed strong expression of bcl-2 and in 23 no staining for this protein was observed. We found statistically significant reverse correlation between expression of p53 and bcl-2 in majority of carcinomas: 31 cases were bcl-2 positive and p53-negative, and 14 tumours were bcl-2-negative and p53-positive. Six carcinomas showed no nuclear staining for Ki-67 and in the remaining 53 the percent of cancer cells positive for Ki-67 ranged from 1 to 60 (mean: 14.6). In these 53 cases we found that bcl-2-positive tumours were characterized by lower proliferation than bcl-2-negative tumours, the mean value of Ki-67 immunostaining being 10.7% and 23.0%, respectively. p53-negative tumours showed lower proliferation than p53-positive tumours: mean Ki-67 index was 10.2% and 23.9%, respectively.We conclude that immunohistochemically detected p53 and bcl-2 proteins show a significant inverse relationship in majority of breast carcinomas and their expression correlates with tumour proliferation (Ki-67 immunostaining).     

Induction of heat shock protein 72 synthesis by endogenous tumor necrosis factor via enhancement of the heat shock element-binding activity of heat shock factor 1

Endogenous tumor necrosis factor (enTNF) acts as a resistance factor against cytotoxicity caused by heat by inducing manganous superoxide dismutase (MnSOD), thereby scavenging reactive oxygen free radicals. On the other hand, it is also well known that heat shock proteins (HSP) which are induced by heat stress behave as cytoprotective factor against this stress. However, the relationship of these two resistance factors is not elucidated yet. In the present study, we therefore proposed the possibility that enTNF enhances HSP72 expression. Heat-sensitive L-M (mouse tumorigenic fibroblast) cells, which normally do not express enTNF, were transfected with a nonsecretory-type human TNF-α expression vector to produce enTNF. Stable transfectants showed resistance to heat treatment and an increase of HSP72 expression. Conversely, when HeLa (human uterine cervical cancer) cells, which normally produce an appreciable amount of enTNF, were transfected with an antisense TNF-α mRNA expression vector to inhibit enTNF synthesis, their heat sensitivity was enhanced and HSP72 expression was reduced by half. Although enTNF caused no difference in the level of heat shock factor (HSF) 1 in these cells, enTNF expression correlated well with the binding activity of HSF-1 to a ³²P-labeled synthetic oligonucleotide containing the human heat shock element (HSE). These results indicate that enTNF participates not only in intrinsic resistance against heat via induction of MnSOD but also via enhancement of the HSE-binding activity of HSF 1 followed by augmentation of HSP72 expression.     

Immunohistochemical analysis of p53 protein overexpression in liver cell dysplasia and in hepatocellular carcinoma

We analysed p53 protein immunoreactivity in hepatocellular carcinomas (HCCs) and in liver cell dysplasia (LCD) of patients from an area in Northern China, using five anti-p53 protein antibodies recognizing different epitopes of the protein. In HCCs, the overall prevalence of p53 protein immunoreactivity was 78.3%. However, prevalence was strongly influenced by the type of antibody used, ranging from 67.5% for antibody PAb-1801 to only 10.8% for antibodies PAb-421 and DO-7. p53 protein immunoreactivity was not related to type or grade of HCC. In contrast to former reports, p53 protein staining was restricted to nuclei only when using the CM-1 antibody, whereas two other antibodies yielded both, nuclear and cytoplasmic or membrane staining, and no nuclear staining was observed with antibodies PAb-421 and DO-7, the latter two, however, demonstrating cytoplasmic and membrane staining. For LCD, three subtypes were morphologically and karyometrically defined. Nuclei of some LCD cells were p53 immunoreactive, but positivity was restricted to the small cell variant of LCD. Positivity was different for cirrhosis with or without associated HCC, amounting to 18.9% in the former and 39.4% in the latter. Interestingly, p53 protein immunoreactivity also occurred in a set of small hepatocytes not showing the typical features of LCD and therefore classified as simple regenerating liver cells.     

Immunohistochemical detection of p53 in differentiated, poorly differentiated and undifferentiated carcinomas of the thyroid

In an attempt to find whether or not p53 immunoreactivity in the thyroid gland is restricted to undifferentiated carcinomas and to evaluate the putative prognostic usefulness of its detection, we investigated p53 immunoreactivity in a series of 14 benign thyroid lesions and 65 thyroid carcinomas (12 papillary; six minimally invasive follicular; four widely invasive follicular; 31 poorly differentiated and 12 undifferentiated tumours). Unequivocal nuclear immunostaining for p53 was observed in two widely invasive follicular carcinoma (20.0%), five poorly differentiated carcinomas (16.1%) and in 10 undifferentiated carcinomas (83.3%). The percentage of immunoreactive cells was much smaller in the former groups than in undifferentiated carcinomas. Despite a trend to a more aggressive behaviour of the p53 immunoreactive cases no significant differences in the outcome of patients with positive and negative tumours was found when the comparison was made within each category of carcinomas. We conclude that p53 immunoreactivity can be detected both in undifferentiated carcinomas and in some differentiated and poorly differentiated thyroid carcinomas. Larger series of cases are necessary to evaluate the prognostic usefulness of this finding.     

Expression of p53 protein in infiltrating and in-situ breast carcinomas.

Five antibodies directed against the whole or part of p53 protein have been used to detect the protein immunohistochemically in 70 infiltrating breast carcinomas and 10 ductal carcinomas in situ. Mutations are known to occur in different conserved domains, and the antibodies employed spanned the expected sites. p53 protein was identified in 53 per cent of infiltrating carcinomas using the antibodies PAb 240, PAb 1801, C19, and JG8. The antibody PAb 421 detected the protein in 31.5 per cent; all positive with the other antibodies. Well-differentiated oestrogen receptor-positive tumours had a low incidence of p53 detection. Variation in the percentage of reactivity was seen between carcinomas and in some cases between different antibodies in the same cancer. Those carcinomas with a high percentage of positive cells with all antibodies were more likely to have metastasized to nodes, be at an advanced stage, and be oestrogen receptor-negative/epidermal growth factor receptor-positive. There was no significant correlation with c-erbB-2 protein expression or retinoblastoma protein loss. p53 protein was detected in a high proportion of cells in three of the six comedo ductal carcinomas in situ studied but either not at all or at a lower level in tumours of the cribriform type. p53 mutations are common in breast carcinomas, but heterogeneity within individual tumours is frequent. Marked expression of p53 appears to relate to tumour progression.     

类风湿关节炎患者关节液中HSP72水平变化与疾病活动性及炎症因子水平相关性分析

目的观察类风湿关节炎(RA)患者关节液中热休克蛋白72(HSP72)的水平变化,并对其与疾病活动性相关指标和细胞因子之间的相关性进行分析。方法采用酶联免疫吸附法(ELISA)检测RA患者和骨关节炎(OA)患者关节液中HSP72、TNF-α、IL-6、IL-10的表达水平。结果活动期RA患者关节液中HSP72水平明显高于非活动期RA患者和OA对照组(P<0.01)。活动期RA患者关节液中TNF-α、IL-6的水平均高于非活动期RA患者和OA对照者(P<0.01),关节液中IL-10在各组之间无显著差异。RA患者关节液中HSP72的水平与血沉(ESR)、C反应蛋白(CRP)、风湿因子(RF)呈正相关;RA患者关节液中HSP72的水平与关节液中TNF-α、IL-6水平呈正相关。结论关节液中HSP72可能与RA的炎症相关,与RA病情活动有关。     

Alteration of the p53 gene of lung carcinomas with sarcomatous transformation (spindle cell carcinoma): analysis of four cases

Lung carcinoma with sarcomatous transformation (LCST) is highly aggressive and characterized by local invasion and/or distant metastasis, which leads to a shorter survival than ordinary lung carcinomas. Therefore, to elucidate whether the malignant potential of the spindle cell element in LCST is associated with the alteration of the p53 gene, four cases were examined by analyses of overexpression of the p53 oncoprotein, mutation of the p53 gene and loss-of-heterozygosity (LOH) at chromosome 17p. In two cases overexpression of the p53 oncoprotein of the spindle cell component showed a higher degree of staining than that of the carcinoma component; LOH was identified in both carcinoma and sarcomatous components in one case, while in contrast, another case showed LOH in the sarcomatous component only. Mutations were clearly detected in two cases; one showed a CTT to CGT transversion in codon 194 of exon 6 in both components, whereas the other showed a CTG to CAG transversion in codon 265 of exon 8 in the sarcomatous component only. On the basis of these observations, it suggested that the sarcomatous component shows a higher frequency of p53 gene abnormalities in comparison to the carcinoma component. These results also suggested that the acquisition of malignant potential in the sarcomatous component, or the morphological alteration of carcinoma cells, is correlated with abnormalities associated with the p53 gene.     

Relationship between abnormal p53 protein and failure to express p21 protein in human breast carcinomas

Alterations in the p53 protein are a common feature in most malignancies, including breast carcinomas. p53 protein alterations contribute to malignant transformation in several ways, through genomic instability and accumulation of additional genetic alterations in other genes, through alteration of the p53-dependent apoptotic pathway, and through downregulation of downstream effector proteins such as p21 (WAF1/CIP1), necessary for cell-cycle growth arrest. Cell-cycle arrest is needed to allow DNA repair after injury. This study examines the relationship between abnormalities in p53 protein and expression of p21 protein in 70 cases selected from a series of 212 sporadic human breast carcinomas. Immunohistochemistry (IHC) was used for detection of p53 and p21 protein expression. Constant denaturant gel electrophoresis (CDGE) was used for detection of mutations in exons 5–8 of the TP53 gene. A highly significant association was found between abnormalities in p53, scored as protein accumulation and/or mutations, and lack of p21 expression. p21 was also shown to be downregulated in samples without p53 alterations, indicating that other mechanisms are also involved in turning off this gene. © 1997 John Wiley & Sons, Ltd.     

p53 Mutation in carcinomas arising in ovarian cystic teratomas

Carcinomas arising in mature cystic teratomas of the ovaries from nine women were examined for the presence of p53 mutations. The nine tumors comprised six squamous cell carcinomas, one squamous cell carcinoma in situ , one undifferentiated small cell carcinoma, and one muco-epidermoid carcinoma. Abnormal nuclear accumulation of the p53 protein was obsenred in four of the tumors. Genomic DNA was extracted from formalin-fixed, paraffin-embedded tissue blocks and subjected to polymerase chain reaction (PCR) for specific amplification of the p53 gene exons 5–8, followed by direct chemiluminescence sequencing analysis. A frameshift mutation in exon 8 (codon 278, CCT > del T; stop at codon 344) was detected in one poorly differentiated squamous cell carcinoma. The samples were also evaluated for the possible association of 'benign' and 'malignant' types of human papillomavirus (HPV) by PCR using universal primer sets. None of the samples contained detectable HPV genome. These data suggest that p53 mutations are relatively uncommon in secondary carcinomas developing in ovarian. dermoid cysts, although the number of samples studied was admittedly small.     

Lymphoepithelioma-like carcinoma of the bladder: three cases with clinicopathological and p53 protein expression study

Lymphoepithelioma-like carcinoma of the bladder is an uncommon neoplasm, of which 49 cases have been described in the English literature, none of which has been studied for p53 protein expression. We studied three muscle-infiltrating cases of this tumor using immunohistochemical, in situ hybridization and polymerase chain reaction (PCR) methods. The three cases were positive for epithelial markers and negative for lymphoid antigens in the tumoral syncytial areas. The intensive infiltrate of small cells was negative for epithelial and positive for lymphoid markers. This population was mainly made up of cytotoxic T-lymphocytes, positive for TIA-1. p53 protein was intensely positive in more than 90% of the epithelial component nuclei, being negative in the lymphoid cells. PCR study did not show mutations on p53. Both lymphocytes and epithelium were negative for Epstein–Barr virus markers, such as the latent membrane protein and EBER (Epstein–Barr-encoded RNA). The prognosis was very good after radiotherapy and chemotherapy treatment, preserving the bladder despite the muscle infiltration. The presence of an intense cytotoxic T-lymphocyte population may be related to this good prognosis. Both aspects, p53 protein status and T-lymphoid population, had never been studied before in bladder lymphoepithelioma-like carcinoma.