Prognostic significance of CEA, Ki67 and p53 in pseudomyxoma peritonei of appendiceal origin

Abstract

Objective To determine the levels of carcinoembryonic antigen (CEA), proliferating nuclear antigen Ki67 and p53 in pseudomyxoma peritonei (PMP) of appendiceal origin and to correlate the levels with clinicopathological characteristics and overall survival. Methods This retrospective study collected data on clinicopathological features and immunohistochemical staining of CEA, Ki67 and p53 in patients with PMP of appendiceal origin. Overall survival was evaluated using Kaplan–Meier plots. Median survival time was estimated by Log-rank tests. Potential prognostic factors were evaluated by Cox proportional hazards regression models. Results A total of 141 patients with PMP of appendiceal origin were enrolled in the study with a median age of 54 years. Of these, 93 (66.0%) were diagnosed with low-grade mucinous carcinoma, 43 (30.5%) with high-grade mucinous carcinoma and five (3.5%) with high-grade with signet ring cells. CEA exhibited ubiquitous immunopositivity in most cases and was not associated with overall survival. Ki67 labelling index (LI) and p53 status were related to histological grade and overall survival. The main pathological indicators affecting survival included histological grade, lymph node involvement, angiolymphatic invasion, Ki67 LI and p53. Conclusion Combined analysis of high Ki67 LI and aberrant p53 may provide the basis for evaluating the biological behaviour of PMP and predicting clinical outcome.

Comprehensive Understanding and Evolutional Therapeutic Schemes for Pseudomyxoma Peritonei

“…Nummela et al 84 found that 56% of their cases were tested out abnormal CEA levels and closely related to PCI scores ( P <0.001). Yan et al 85 reported that CEA expressed immunopositivity in a majority of cases and had no relevant accordance with OS. CA19-9 showed strong staining in the multitude of PMP cases.…”

“…Peritoneal lesions that accord with morphologic and cytologic characteristics of carcinoma as more abundant epithelium proliferate in glands, nests, or individual cells, with or without an associated primary mucinous adenocarcinoma Hybrid tumors Peritoneal mucinous adenocarcinoma with intermediate features Bradley et al 61 Low Yan et al 85 reported that CEA expressed immunopositivity in a majority of cases and had no relevant accordance with OS. CA19-9 showed strong staining in the multitude of PMP cases.…”

“… 103 A retrospective study analyzed the levels of Ki-67 and p53 of 141 patients with PMP of appendiceal origin, and it hypothesized that high Ki-67 labeling index combined with aberrant p53 may provide the basis for a bad outcome. 85 …”

“…P53 mutant type (Mtp53) fails to touch off activation of signaling cascades to initiate DNA repair or programmed cell death 103. A retrospective study analyzed the levels of Ki-67 and p53 of 141 patients with PMP of appendiceal origin, and it hypothesized that high Ki-67 labeling index combined with aberrant p53 may provide the basis for a bad outcome 85…”

Novel Perspectives in Pseudomyxoma Peritonei Treatment

“…More recent studies were aimed at confirming the hypothesis that Ki67 quantification might have a prognostic significance in PMP. Indeed, Ki67 score was recently significantly associated with histological grade and survival, in addition to aberrant detection of p53, lymph node metastases and angiolymphatic invasion [ 54 ]. A cut-off value of 15% for Ki67 staining was found to subdivide high-grade PMP into two distinct groups, with a statistically significant difference in OS and disease-free survival [ 55 ].…”