Prognostic significance of p53 expression in oral squamous cell carcinoma without neck node metastases

• Published in: Head & neck Vol. 26; no. 1; pp. 22 - 30
• Main Authors: Carlos de Vicente, Juan, Junquera Gutiérrez, Luis Manuel, Zapatero, Agustín Herrero, Fresno Forcelledo, Manuel Florentino, Hernández-Vallejo, Gonzalo, López Arranz, Juan Sebastián
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.01.2004; John Wiley & Sons
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - metabolism; Carcinoma, Squamous Cell - mortality; Data processing; Differentiation; Female; Head; Humans; Immunohistochemistry; Male; Malignancy; Medical sciences; Metastases; Middle Aged; Mouth Neoplasms - metabolism; Mouth Neoplasms - mortality; Multivariate analysis; Neck; Nodes; Nuclei; oral carcinoma; Oral cavity; oral squamous cell carcinoma; Otorhinolaryngology. Stomatology; p53; p53 protein; Predictive Value of Tests; Prognosis; Retrospective Studies; Risk assessment; squamous cell carcinoma; Survival; Tumor Suppressor Protein p53 - metabolism; Tumors; Human; Immunohistochemistry; Squamous cell carcinoma; N0; Prognosis; Stomatology; ENT; oral squamous cell carcinoma; Malignant tumor; Metastasis; p53; Oral cavity; Anatomic pathology; TP53 Gene; Neck; Tumor suppressor gene
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.10339

Background. Aberrations of the p53 gene and overexpression of its protein are widely recognized markers of malignancy including oral squamous cell carcinomas. This study was performed to evaluate the relationship of immunoexpression of p53 protein in series of 91 squamous cell carcinomas of the oral cavity with clinicopathologic parameters and to investigate whether p53 immunoexpression might influence the clinical outcome of the disease. Methods. From a group of 287 consecutive patients, 91 surgically treated ones were randomly selected. P53 protein expression was investigated by means of immunohistochemistry. Clinical and histopathologic data were gathered, and the patient survival was analyzed. Results. Of the oral carcinomas, 52.7% (n = 48) overexpressed p53, using a threshold of 10% stained cell nuclei. There was a negative correlation of p53 immunoexpression with a histologic grade of differentiation (r = −0.236, p = .06) but not with clinical variables. Overall survival rate was 59% at 5 years. In univariate analysis, tumor size, node status, and advanced clinical stage were significantly associated with shortened overall survival. In patients without neck node metastases, p53 showed a strong correlation with survival (p = .01). In multivariate analysis performed only on N0 patients, tumor extension and p53 immunoexpression were found to be the only independent prognostic parameters with relative risks of 1.9 and 4.3, respectively. Conclusions. A strong relationship was observed between p53 immunoexpression and poor prognosis in patients with oral squamous cell carcinomas without neck node metastases. © 2004 Wiley Periodicals, Inc. Head Neck 26: 22–30, 2004