Prognostic Factors in the Patients with Carcinoma of the Middle and Lower Bile Duct -Analysis of Nuclear DNA Content, MIB-1 Score and Expression of the p53 Protein-

Yasuo Yamada, Hidemi Yamauchi, Kenji Kakizaki

Department of Surgery, Sendai National Hospital

In order to evaluate prognostic factors in patients with carcinoma of the middle and lower bile duct, MIB-1/Ki-67-derived tumor proliferative activity, expression of p53 protein and nuclear DNA content together with clinicopathology were studied retrospectively. Cytophotometric DNA analysis was performed in 20 of 28 specimens. MIB-1 and p53 were measured by immunohistochemistry in all specimens by the avidin-biotin complex method. The MIB-1 score was defined as the percentage of MlB-l-positive cells. There were significant differences in survival between the stage IV and stage I∼III groups, and between the patients with pancreatic infiltration and those without it (p<0.05) . When the cut-off point of the mean DNA content was set at 5c, the patients with mean DNA content over 5c had a significant survival disadvantage compared with those below 5c (p<0.05). The patients with MIB-1 scores below 10% had a significant survival advantage compared with those over 10% (p<0.01). The survival was not affected by expression of p53 protein. Histological factors and stage did not correlate with mean DNA content, MIB-1 score or expression of p53. A significant linear correlation was observed between mean DNA content and MIB-1 score. These results suggest that the mean DNA content and MIB-1 score may be significant prognostic factors independent of histological factors and that expression of p53 protein does not affect the clinical outcome in patients with carcinoma of the middle and lower bile duct.

Key words
carcinoma of the middle and lower bile duct, nuclear DNA content, MIB-1, Ki-67, p53 protein

Reprint requests
Yasuo Yamada Department of Surgery, Sendai National Hospital
2-8-8 Miyagino, Miyagino-ku, Sendai, 983 JAPAN

Accepted
September 9, 1997

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