Abnormal p53 immunohistochemistry is associated with an increased colorectal cancer-related mortality in patients with ulcerative colitis.
OBJECTIVE
Immunohistochemical evaluation of p53 staining patterns has been considered as a complementary test for dysplasia in ulcerative colitis-related colorectal cancer surveillance, but usefulness would be particularly important if it were a marker associated with a poor prognosis. The aim of this study was to determine whether abnormal p53 staining of the tumor correlated with cancer-related mortality in ulcerative colitis patients.


METHODS
An historical cohort study was designed to examine all ulcerative colitis patients who developed colorectal cancer between 1978 and 1997 and who had tumor tissue blocks available for staining. Tissue was recut and stained for abnormal p53 immunohistochemistry using the DO-7 antibody. Tumors were considered to be p53 positive if at least 5% of nuclei in a high power field were positive for staining.


RESULTS
Among 75 patients entered in the study, 38 (50.7%) had p53 positive tumors. Fourteen patients (36.8%) with p53 positive tumors died from colorectal cancer, compared to five (13.5%) with p53 negative tumors (p < 0.04, log-rank test). The adjusted relative risk of cancer-related death among patients with p53 positive tumors was 3.03 (95% CI = 1.05-8.73).


CONCLUSIONS
Abnormal p53 immunohistochemistry of tumors is associated with a poor prognosis among ulcerative colitis patients who develop colorectal cancer. As such, p53 immunohistochemical staining could be a useful histological marker to complement routine histology in cancer surveillance programs in ulcerative colitis patients.
Lashner
Bret A
BA
Center for Inflammatory Bowel Disease, Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Bauer
William M
WM
Rybicki
Lisa A
LA
Goldblum
John R
JR
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications / Q000235:genetics*; D015179:Colorectal Neoplasms / Q000150:complications / Q000235:genetics* / Q000401:mortality* / Q000473:pathology; D005260:Female; D016158:Genes, p53 / Q000235:genetics*; D005819:Genetic Markers; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
D005819:Genetic Markers; D016159:Tumor Suppressor Protein p53