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2006 | 4 | 4 | 220-229
Article title

Analiza wybranych czynników molekularnych i klinicznych u pacjentek leczonych z powodu raka jajnika taksanami i cisplatyną

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Analysis of selected molecular and clinical factors in patients with ovarian cancer treated with taxanes and cisplatin
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Abstracts
EN
Introduction: Paclitaxel and platinum analogs are standard drugs implemented as first-line therapy in advanced ovarian cancer, after previous surgery. One of causes of resistance to therapy is, among others, disruption of mechanisms leading to cell apoptosis. Aim of the paper is to determine the significance of expression of TP53, BAX and BCL-2 in response to first-line chemotherapy using paclitaxel in patients with advanced ovarian cancer, as well as to assess the role of TP53 as a prognostic and predictive factor in ovarian cancer. Material and method: The study included 164 patients with advanced ovarian cancer. Immunohistochemical staining was performed on histological specimens obtained from paraffin blocks. Monoclonal antibodies anti-BAX, anti-BCL-2 and anti-p53 were used. Results: Accumulation of TP53 was noticed in 60% of tumors. BCL-2 was absent in half of tumors studied. Significant expression of BCL-2 was noticed in 24% of tumors, while that of BAX was seen in 34% of tumors. There was a correlation of histological grade, volume of residual tumor left after surgery and BAX expression with overall survival. Enhanced expression of BAX correlated directly with increased death risk. Accumulation of none of proteins studied had any influence on disease-free survival. Complete remission was obtained in 106 patients. Size of residual tumor has a significant impact on disease-free survival. Conclusions: 1) In ovarian cancer patients, clinical factors clearly have far greater prognostic value than molecular factors. 2) There was no correlation between TP53 expression and clinical response to first-line chemotherapy using paclitaxel, cisplatin or platinum analogs. 3) TP53 expression is not a prognostic or predictive factor in ovarian cancer.
PL
Wstęp:Paklitaksel i analogi platyny są standardem postępowania w pierwszej linii leczenia w zaawansowanym raku jajnika, po uprzedniej chirurgii. Przyczyną oporności na leczenie jest między innymi uszkodzenie mechanizmów prowadzących do apoptozy. Celem naszej pracy jest określenie znaczenia ekspresji TP53, BAX i BCL-2 w odpowiedzi na chemioterapię pierwszej linii z zastosowaniem paklitakselu u pacjentek z zaawansowanym rakiem jajnika, jak również ocena TP53 jako czynnika prognostycznego i predykcyjnego w raku jajnika. Materiał i metody: Badanie przeprowadzono u 164 chorych z zaawansowanym rakiem jajnika. Barwienia immunohistochemiczne zostały wykonane na materiale z bloczków parafinowych. Stosowano przeciwciała monoklonalne anty-BAX, anty-BCL-2 i anty-p53. Wyniki: Akumulację TP53 stwierdzono w 60% guzów. Obecności BCL-2 nie wykazano w połowie badanych guzów. Silną ekspresję BCL-2 stwierdzono w 24%, zaś silną ekspresję BAX – w 34% guzów. Wykazano wpływ histologicznego stopnia zaawansowania, wielkości pozostawionych resztek oraz ekspresji BAX na całkowite przeżycia. Przy silnej ekspresji BAX ryzyko zgonu było większe. Akumulacja żadnego białka nie miała wpływu na długość czasu wolnego od choroby. Całkowitą remisję uzyskano u 106 pacjentek. Wielkość pozostawionych resztek miała znaczący wpływ na długość czasu wolnego od choroby. Wnioski: 1) Czynniki kliniczne mają zdecydowanie większe znaczenie prognostyczne niż czynniki molekularne w raku jajnika. 2) Nie zaobserwowano związku pomiędzy stanem TP53 a odpowiedzią na leczenie pierwszej linii chemioterapii z zastosowaniem paklitakselu i cisplatyny lub analogów platyny. 3) Nie wykazano znaczenia TP53 jako czynnika prognostycznego i predykcyjnego w raku jajnika.
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Year
Volume
4
Issue
4
Pages
220-229
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References
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