Expression of p53 protein in advanced head and neck squamous cell carcinoma before and after chemotherapy.
BACKGROUND
The expression of p53 protein has been reported to be in the range of 35% to 67% in head and neck squamous cell carcinoma (HNSCC). Mutations of the gene for p53 protein have been associated with rapidly proliferating tumors, and p53 protein expression has been shown to be a significant predictor of worse survival in surgically resected HNSCC. To determine whether p53 protein expression in advanced (stages III and IV) HNSCC has any impact on tumor response to 2 to 3 courses of paclitaxel (Taxol) and carboplatin, we prospectively studied prechemotherapy specimens from patients with previously untreated, advanced-stage HNSCC. We also attempted to study residual tumors after chemotherapy to determine if the p53 status of the tumor changed.


METHODS
The expression of p53 protein was evaluated by immunohistochemical analysis (clone BP53-12-1; Bio-Genex, San Ramon, Calif).


METHODS
Tertiary university medical center.


METHODS
Two to 3 courses of chemotherapy with paclitaxel and carboplatin.


METHODS
Pathologic complete remission or residual tumor.


RESULTS
The results of p53 immunostaining were positive in 24 (67%) of 36 HNSCC specimens before chemotherapy. After chemotherapy, 8 patients achieved pathologic complete remission. Before chemotherapy, the tumor was p53 negative in 2 patients and positive in 6 patients.


CONCLUSIONS
No correlation of p53 protein expression with response to chemotherapy was noted. The expression of p53 protein converted from positive to negative in 5 (42%) of 12 specimens from patients with residual tumor after chemotherapy, with no impact on clinical outcome.
Dunphy
C H
CH
Department of Pathology, St Louis University Health Sciences Center, Mo., USA.
Dunphy
F R
FR
Boyd
J H
JH
Varvares
M A
MA
Kim
H J
HJ
Lowe
V
V
Dunleavy
T L
TL
Rodriguez
J
J
McDonough
E M
EM
Minster
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000737:chemistry* / Q000188:drug therapy* / Q000473:pathology; D004334:Drug Administration Schedule; D006258:Head and Neck Neoplasms / Q000737:chemistry* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009154:Mutation; D018365:Neoplasm, Residual; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D016159:Tumor Suppressor Protein p53 / Q000235:genetics / Q000378:metabolism*
D016159:Tumor Suppressor Protein p53; D016190:Carboplatin; D017239:Paclitaxel