Analysis of the immunohistochemical expressions of p53, bcl-2 and Ki-67 in colorectal adenocarcinoma and their correlations with the prognostic factors
Purpose: To analyse the immunohistochemical expressions of the proteins p53, bcl-2 e Ki-67 in colorectal adenocarcinoma and correlate it with the clinical pathological prognostic factors. Methods: A TMA paraffin block was constructed with colorectal carcinoma tissue of 82 patients who had undergone surgery in the Hospital Sao Paulo-UNIFESP, from 2002 to 2005, submitted neither to chemo or radiotherapy. Four ìm sections from the was submitted to immunohistochemistry and immunoexpression staining scores were obtained, than was correlated with the degree of cellular differential, stage, relapse-free survival, relapse, survival and specific mortality. The variables of the study were analyzed by tests of the qui-square and Kaplan-Meyer to verify the markers association. The significance of the differences between the curves of relapse-free survival and of the overall survival was analyzed by tests of lgrank and Wilcoxon. Results: The immunohistochemical expression of the p53 was found to be positive in 70 tumours (85,4%) and negative in 12 (14,6%). The bcl-2 was found to be positive in 26 (31,7%) and negative in 56 (68,3%). The immunohistochemical expression of the ki-67 was found to be positive in 62 (75,6%) and negative in 20 (24,4 %). There was no correlation statistically significant between the markers expressions separately and in conjunction, involving the degree of cellular differentiation, stage, relapse-free survival, survival and specific mortality. With respect the relapse, there was a correlation statistically significant with the positive expression of the ki-67 (p53=0,035). Conclusion: The immunohistochemical expression of the Ki-67 in colorectal cancer is related to the incidence of the relapse of the disease.Objetivo: Analisar as expressoes imunohistoquimicas das proteinas p53, bcl-2 e Ki-67 no adenocarcinoma colorretal, correlacionando-as com os fatores prognosticos clinico-patologicos. Metodo: Foram confeccionados blocos de parafina de TMA com tecido de adenocarcinoma colorretal ressecados cirurgicamente em 82 pacientes no Hospital Sao Paulo da UNIFESP/EPM, de 2002 a 2005, nao submetidos a radio ou quimioterapia. Cortes de 4 ƒÊm foram submetidos a reacao imunohistoquimica e obtidos escores de intensidade das imunoexpressoes, que foram correlacionados com o grau de diferenciacao celular, estadiamento, tempo livre de doenca, recidiva, sobrevida e mortalidade especifica entre si e com os dados de sobrevida dos pacientes. As variaveis do estudo foram analisadas pelos testes do qui-quadrado e de Kaplan-Meier para verificar as associacoes com os marcadores. A significancia das diferencas entre as curvas do tempo livre de doenca e da sobrevida foi analisada pelos testes de Logrank e Wilcoxon. Resultados: A expressao imunohistoquimica da p53 foi positiva em 70 tumores (85,4%) e negativa em 12 (14,6%). A bcl-2 foi positiva em 26 tumores (31,7%) e negativa em 56 (68,3%). A expressao imunohistoquimica da Ki-67 foi positiva em 62 tumores (75,6%), sendo em 20 (24,4%) negativa. Nao houve correlacao estatisticamente significante entre as expressoes imunohistoquimicas dos marcadores analisadas separadamente ou em conjunto, envolvendo o grau de diferenciacao celular, estadiamento, tempo livre de doenca, sobrevida e mortalidade especifica. Com relacao a recidiva, observou-se uma correlacao estatisticamente significante com a expressao imunohistoquimica positiva da Ki-67 (p= 0,035). Conclusao: A expressao imunohistoquimica positiva da Ki-67 no cancer colorretal esta relacionada com a incidencia de recidiva da doenca.TEDEBV UNIFESP: Teses e dissertaçõe