Published in Cancer Detection and Prevention 1998; 22(2):120-128.
Immunohistochemical Prediction of Radiation Response and Local Control in Radiation Therapy for Cervical CancerDivision of Radiation Medicine, National Institute of Radiological Sciences, Chiba, Japan
Address all correspondence and reprint requests to: Takashi Nakano, M.D., Division of Radiation Medicine, National Institute of Radiological Sciences, 9-1, Anagawa-4-chome, Inage-ku, Chiba-shi 263, Japan.
ABSTRACT: Prognosis of 64 cervical cancer patients treated with radiation therapy was analyzed by tumor expressions of c-erbB-2 oncoprotein (CerbB-OPE) and p53 protein (p53-PE), Ki-67 growth fraction (Ki-GF), and the mitotic index of proliferating cell population (pMI). Positivity of CerbB-OPE and p53-PE was 42.4 and 84.6, respectively. Mean Ki-GF and pMI were 33.0 and 2.7%, respectively. Mean Ki-GF for CerbB-OPE was 38.3%, significantly higher than the 26.2% for the negative patients (p < 0.01). The mean pMI for CerbB-OPE was 2.00%, significantly lower than the 3.70% of the negative patients ((p < 0.05). The 5-year survival rate of CerbB-OPE-positive patients was 44.4%, significantly lower than the 74.8% of negative patients (p <0.01). The survival rates of Ki-GF < 33% was 44.7%, significantly lower than the 87.5% of Ki-GF > 33% (p < 0.01). The survival rates of pMI >= 3.5 was 0%, significantly lower than the 81.8% of pMI < 3.5% (p <0.001). The survival rates of p53-PE-positive and negative patients were 52.8 and 85.0%, respectively (p > 0.1). The poor prognosis of the cervical cancer with CerbB-OPE, lower Ki-GF, and higher pMI were due to local recurrence following radiation therapy. Multiple regression analysis indicated that pMI was the strongest prognostic factor and was followed by CerbB-OPE, tumor volume, and Ki-GF. In conclusion, the c-erbB-2 oncoprotein expression, Ki-67 growth fraction, and the mitotic index of proliferating cell population were considered to be effective prognostic factors in radiation therapy for cervical cancer.