Evaluation of p53 protein as a prognostic factor for oral cancer surgery

• Published in: British journal of oral & maxillofacial surgery 2013-12, Vol.51 (8), p.922-927
• Main Authors: Cutilli, Tommaso, Leocata, Pietro, Dolo, Vincenza, Altobelli, Emma
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Antimetabolites, Antineoplastic - administration & dosage; Antineoplastic Agents - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor - analysis; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - surgery; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; Dentistry; Drug Resistance, Neoplasm; Female; Fluorouracil - administration & dosage; Follow-Up Studies; Gene Expression Regulation, Neoplastic - genetics; Humans; Lymphatic Metastasis - pathology; Male; Middle Aged; Mouth Neoplasms - pathology; Mouth Neoplasms - surgery; Multimodal treatment; Mutation - genetics; Neoadjuvant Therapy; Neoplasm Grading; Neoplasm Staging; Oral cancer; p53 Status; Prognosis; Sex Factors; Surgery; Survival Rate; Tumor Suppressor Protein p53 - analysis; Tumor Suppressor Protein p53 - genetics
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1016/j.bjoms.2013.05.150

Abstract We have analysed concentrations of the p53 protein in advanced oral carcinomas immunohistochemically and genetically to detect the percentage of overexpression of this antioncogene that indicates a high probability of mutation. This would point to it being a useful prognostic factor, if we consider the importance of the relation between genetic alterations of p53 and poor overall survival. Seventy-five non-consecutive patients with oral squamous cell carcinoma and metastatic nodes were enrolled if there was homogeneity in histopathological grading (G2) of their tumours, and they were treated according to a multidisciplinary treatment plan. Monoclonal antibodies, extraction of DNA, and amplification of the polymerase chain reaction (PCR) were used for the immunohistochemical and genetic analyses. There was a significant inverse correlation between p53 overexpression and response to chemotherapy and a stronger association between high P53 overexpression (%) and a genetic mutation of p53 ( p = 0.0001). More than 50% overexpression indicated a strong probability of genetic mutation. There was no association between response to chemotherapy and age-groups or TNM classification ( p = 0.2), but there was a significant one between sex and site of tumour ( p < 0.001). Three prognostic factors were significantly related to prognosis: site of tumour ( p = 0.01), response to chemotherapy ( p = 0.002), and immuno p53 ( p = 0.0001). A tumour that is characterised by p53 overexpression of more than 50% indicates a poor prognosis.