The combined evaluation ofp53 accumulation and of Ki-67 (MIBI) labelling index provides independent information on overall survival of ovarian carcinoma patients

Summary Background The prognostic implications of p53 accumulation, bcl-2 immunoreactivity and tumour proliferative fraction in ovarian carcinomas are still debated. Patients and Methods One hundred twelve ovarian carcinomas were immunostained for p53 protein,for bcl-2 and for the cell cycle-associated Ki-67 antigen. The immunostaining results were correlated with conventional clinico-pathological variables, response to induction chemotherapy, and patient survival. Results p53 accumulation and bcl-2 immunoreactivity in more than 10% of neoplastic cells were detected in 61 (54.5%) and 42 (37.5%) cases, respectively. A positive correlation between p53 accumulation and high (more than 30% neoplastic cells) MIBl labelling index (r = 0.235; P = 0.015) was ascertained, whereas no significant association was found between bcl-2 immunoreactivity and p53 accumulation or MIBI labeling index. Both p53 accumulation and MIBI immunoreactivity correlated significantly with a reduced overall survival, but the association was lost in multivariate analysis. However, patients with tumours simultaneously showing p53 accumulation and MIBI labelling index higher than 30% had significantly reduced overall survivals, in both univariate and multivariate analyses. Conclusions The simultaneous evaluation of p53 accumulation and MIBI labelling index has independent prognostic implications in common epithelial malignancies of the ovary, irrespective of the disease stage.