Prognostic significance of mutant p53 protein, P-glycoprotein and glutathione S-transferase-pi in patients with unresectable non-small cell lung cancer.
BACKGROUND
The prognostic significance of mutant p53 protein, p-glycoprotein (P-gp) and glutathione S-transferase-pi (GST-pi) in patients with unresectable non-small cell lung cancer (NSCLC) has not been established.


METHODS
We performed immunohistochemical staining of p53, P-gp and GST-pi using transbronchial biopsy specimens obtained from previously untreated NSCLC patients.


RESULTS
Of 45 patients examined, p53 immunostaining was positive in 18 (40%) patients. The objective response rate by cisplatin (CDDP)-based chemotherapy was significantly lower in patients with p53-positive tumors compared to those with p53-negative tumors (22% versus 59%, p = 0.0143). Survival of the patients with p53-positive tumors was significantly shorter than those with p53-negative tumors (median survival time: 4.6 months versus 12.2 months, p = 0.011), which was confirmed by the multivariate analysis (p = 0.0243). However, P-gp and GST-pi showed no significant relationship with either response rate or survival in patients with unresectable NSCLC receiving CDDP-based chemotherapy.


CONCLUSIONS
p53 alteration is an independent and significant indicator to predict unfavorable prognosis in patients with unresectable NSCLC.
Miyatake
Kazuyo
K
Department of Internal Medicine II, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
Gemba
Kenichi
K
Ueoka
Hiroshi
H
Nishii
Kenji
K
Kiura
Katsuyuki
K
Tabata
Masahiro
M
Shibayama
Takuo
T
Takigawa
Nagio
N
Kawaraya
Masashi
M
Tanimoto
Mitsune
M
D018435:ATP Binding Cassette Transporter, Subfamily B / Q000096:biosynthesis / Q000235:genetics*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology; D001706:Biopsy; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005982:Glutathione Transferase / Q000096:biosynthesis / Q000235:genetics*; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis / Q000235:genetics*
D018435:ATP Binding Cassette Transporter, Subfamily B; D016159:Tumor Suppressor Protein p53; D005982:Glutathione Transferase; D002945:Cisplatin