title: P53 expression as a predictor of recurrence in cervical squamous cell carcinoma.
abstract: P53 protein function is frequently down-regulated in cervical cancer by complexing with human papillomavirus (HPV) E6 protein, leading to degradation of p53, genomic instability, and mutations. Results are controversial, however, on the prognostic value of p53 protein expression in cervical cancer. In this study, a cohort of 220 Brazilian women with FIGO stage IB-III cervical squamous cell carcinoma (SCC), followed for 5 years, was analyzed for p53 protein expression using immunohistochemistry. The disease-free survival (DFS) and relapse rate were analyzed using univariate (Kaplan-Meier) and multivariable (Cox's proportional hazards model) survival analyses. P53 protein expression was detected in 35% of the patients, including 21% in stage I, 28% in stage II and 51% in stage III of disease. Of 220 women, only 116 completed one of the treatment options standardized by FIGO within 120 days. There was a higher risk of relapse in stage II and III disease, that was not modified by p53 positivity; HR 3.0 (1.3-6.5) to stage II and HR 4.0 (1.9-8.5) to stage III. The multivariate analysis evidenced that p53 expression is not an independent factor exceeding the power of FIGO stage as the single most important determinant of the hazards for disease relapse.
authors.affiliation: Gynecologic Oncology Group, Maternity Hospital Leonor Mendes de Barros, The Health State Secretariat, Avenue Celso Garcia 2477, 03015-000 São Paulo, Brazil. brenna.ops@zaz.com.br
authors.forename: Sylvia M F
authors.initials: SM
authors.lastname: Brenna
authors.forename: L C
authors.initials: LC
authors.lastname: Zeferino
authors.forename: G A
authors.initials: GA
authors.lastname: Pinto
authors.forename: R A
authors.initials: RA
authors.lastname: Souza
authors.forename: L A L
authors.initials: LA
authors.lastname: Andrade
authors.forename: J
authors.initials: J
authors.lastname: Vassalo
authors.forename: E Z
authors.initials: EZ
authors.lastname: Martinez
authors.forename: K J
authors.initials: KJ
authors.lastname: Syrjänen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000628:therapy; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism* / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*; D002583:Uterine Cervical Neoplasms / Q000378:metabolism* / Q000628:therapy
chemical_list: D014408:Biomarkers, Tumor; D016159:Tumor Suppressor Protein p53