Clinical significance of p21(WAF1/CIP1) and p53 expression in serous cystadenocarcinoma of the ovary.
ABSTRACT There have been many reports indicating that the down-regulation of p21(WAF1/CIP1) is related to carcinogenesis and the development of various tumors; nevertheless, its association with epithelial ovarian cancer (EOC) remains controversial. In this study, we focused on serous ovarian cancer, which is the most prevalent histological type, and performed immunohistochemical analysis to examine the expression of p21(WAF1/CIP1) and p53 in 43 cases of serous-type EOC sourced from a single University Hospital: 14 stage I, 4 stage II, 21 stage III, and 4 stage IV. Positive p21(WAF1/CIP1) was found in 24 of 43 cases (56%), and positive p53 was detected in 21 of 43 cases (49%). Among stage III/IV cases, positive p21(WAF1/CIP1) staining was found in 11 of 25 cases (44%), and positive p53 staining was detected in 13 of 25 cases (52%). Univariate survival analysis for the entire cohort revealed that positive p21(WAF1/CIP1) was associated with a survival benefit. The 10-year survival rates of p21(WAF1/CIP1)-positive staining and p21(WAF1/CIP1)-negative staining were 82.4 and 39.5%, respectively, and there was a significant difference between the two groups (p<0.01). Overall survival for p21(WAF1/CIP1)-positive with p53-negative staining [p21(+)/p53(-)] was significantly different from p21(WAF1/CIP1)-positive with p53-positive [p21(+)/p53(+)], p21(WAF1/CIP1)-negative with p53-positive staining [p21(-)/p53(+)], and p21(WAF1/CIP1)-negative with p53-negative staining [p21(-)/p53(-)] (p<0.05). When only III/IV cases were evaluated, overall survival for [p21(+)/p53(-)] was significantly different from [p21(+)/p53(+)], [p21(-)/p53(+)], and [p21(-)/p53(-)] (p<0.05). These results suggested that the overexpression of p21(WAF1/CIP1) in conjunction with the loss of p53 expression was a stronger predictor of survival benefit than either molecule alone in Japanese serous-type advanced ovarian cancers with more than 10-year follow-up.
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ABSTRACT: Stage IA vulvar cancer with a depth of stromal invasion less than 1 mm is generally managed by wide local excision alone since there is less than 1% risk of lymph node involvement. A 62-year-old patient was admitted to a university hospital with a suspicious vulvar lesion. We present the first case of inguinal node and a possible contralateral pubic ramus recurrence following bilateral superficial inguinal lymphadenectomy and wide local resection for Stage 1A vulvar cancer. There is no evidence that extended radical surgery provides a better overall survival or reduces recurrence rate in Stage 1A vulvar carcinomas. Conservative vulvar resection and sentinel node dissection seem to be a rational choice. Nevertheless the disease may recur in the inguinal areas and frequently be lethal, therefore close surveillance and early attempts to treat the recurrent disease before infection and inflammation ensues should be the aim of current treatment strategies.European journal of gynaecological oncology 01/2010; 31(3):354-6. · 0.60 Impact Factor
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ABSTRACT: To examine the relevance of expression of two proteins essential for DNA replication initiation, Mcm3 and Mcm4, in cervical squamous cell carcinoma (CSCC). 53 cases of cervical squamous cell carcinoma, 35 cervical intraepithelial neoplasias (CIN) grade 2-3, 11 CIN I and 26 normal controls were studied. Immunohistochemistry was performed with anti-Mcm3 and anti-Mcm4 antibodies. We found Mcm3 and Mcm4 protein expression had a tendency to be stronger from control to CSCC. Both Mcm3 and Mcm4 were significantly upregulated in squamous cervical carcinoma compared to the control, CIN grade 1 and grade 2-3 (p < 0.001), and Mcm3 expression was correlated with CSCC cell differentiation. However there were no independent prognosis correlations between Mcm3 and Mcm4 and clinicopathological parameters including age, stage, tumor size, invasive depth and lymph node metastasis. Mcm3 and Mcm4 were highly expressed in CSCC, and these two proteins might be useful as biomolecular markers in clinical diagnosis.European journal of gynaecological oncology 01/2010; 31(3):291-4. · 0.60 Impact Factor
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ABSTRACT: Ovarian granulosa cell tumours (GCT) occur rarely and represent 2-3% of all ovarian tumours. Regarded as tumours with low malignant potential and renowned for late recurrences, these tumours occasionally metastasize to the liver. We present our experience with three patients who underwent secondary cytoreductive surgery including liver resection for recurrence of the disease resulting in greatly improved quality of life and disease-free interval.European journal of gynaecological oncology 01/2010; 31(3):342-4. · 0.60 Impact Factor