Immunohistochemical Prediction of Radiation Response and Local Control in Radiation Therapy for Cervical Cancer

Prognosis of 64 cervical cancer patients treated with radiation therapy was analyzed by tumor expressions of c-erbB-2 oncoprotein (CerbB-OPE) and p53 protein (p53-PE), Ki-67 growth fraction (Ki-GF), and the mitotic index of proliferating cell population (pMI). Positivity of CerbB-OPE and p53-PE was 42.4% and 84.6%, respectively. Mean Ki-GF and pMI were 33.0% and 2.7%, respectively. Mean Ki-GF for CerbB-OPE was 38.3%, significantly higher than the 26.2% for the negative patients (p < 0.01). The mean pMI for CerbB-OPE was 2.00%, significantly lower than the 3.70% of the negative patients (p < 0.05). The 5-year survival rate of CerbB-OPE-positive patients was 44.4%, significantly lower than the 74.8% of negative patients (p < 0.01). The survival rates of Ki-GF < 33% was 44.7%, significantly lower than the 87.5% of Ki-GF > or = 33% (p < 0.01). The survival rates of pMI > or = 3.5% was 0%, significantly lower than the 81.8% of pMI < 3.5% (p < 0.001). The survival rates of p53-PE-positive and negative patients were 52.8% and 85.0%, respectively (p > 0.1). The poor prognosis of the cervical cancer with CerbB-OPE, lower Ki-GF, and higher pMI were due to local recurrence following radiation therapy. Multiple regression analysis indicated that pMI was the strongest prognostic factor and was followed by CerbB-OPE, tumor volume, and Ki-GF. In conclusion, the c-erbB-2 oncoprotein expression, Ki-67 growth fraction, and the mitotic index of proliferating cell population were considered to be effective prognostic factors in radiation therapy for cervical cancer.