Prognostic Significance Of Expression Of P53, PIK3CA, PTEN And C-erbB-2 In Cervical Carcinoma

Objective:To study the association of expression of P53, PIK3CA, C-erbB-2 and PTEN with clinical pathological features and the prognosis of early stage squamous cell carcinoma of cervix.Methods:We used immunohistochemical assay to detect the expression of P53, PIK3CA, C-erbB-2 and PTEN in 80 cervical tissues collected in ZheJiang Cancer Hospital from January,2008 to January,2009, including 50 cervical squamous cell carcinomas(26 cases of stage Ⅰb,24 cases of stage Ⅱa) and 30 normal cervixes.Results:The expression of P53, PIK3CA and C-erbB-2 were negative, PTEN was positive in normal cervical tissue. The expression of P53, PIK3CA and C-erbB-2 had increased and PTEN had decreased in cervical squamous cell carcinoma. In 50 cases of cervical squamous cell carcinoma,38 cases had P53 positive expression (76.0%),40 cases had PIK3CA positive expression (80%),35 cases had C-erbB-2 positive expression (70.0%), 12 cases had PTEN expression (24.0%). Compared with normal cervical tissue, the cases of P53, PIK3CA, C-erbB-2, PTEN expressed differently (P<0.05). The expression of P53, PIK3CA, C-erbB-2 and PTEN closely connected with tumor differentiation and clinical stage, P53 and PTEN closely connected with tumor size and stromal invasion depth, PIK3CA and C-erbB-2 closely connected with lymph node metastasis, PTEN closely connected with vascular invasion (P<0.05). P53 and PIK3CA (r= 0.82), P53 and C-erbB-2 (r= 0.89), PIK3CA and C-erbB-2 (r= 0.78) were positively correlated (P<0.05), P53 and PTEN (r=-0.81), PIK3CA (r=-0.87) and PTEN, C-erbB-2 and PTEN (r=-0.91) were negatively correlated (P<0.05). The follow-up time of 50 cases cervical squamous cell carcinoma was from 72 to 80 months, with median of 76 months.5 cases died (10.0%). Among 45 cases alive(90.0%),7 cases transferred (14.0%). Unvaried analysis showed that lymph node metastasis, P53, PIK3CA, C-erbB-2 and PTEN expression had closely related to the prognosis of cervical squamous cell carcinoma (P<0.05), multivariate analysis showed that P53, PIK3CA, C-erbB-2 and PTEN expression were independent risk factors related to the prognosis of cervical squamous cell carcinoma (P<0.05).Conclusion:P53, PIK3CA, C-erbB-2 and PTEN may be useful in predicting prognosis in squamous cell carcinoma of cervix. The patients with P53(+)/PIK3CA(+)/PTEN(-)/ C-erbB-2(+) indicate poorer prognosis.