Prognostic significance of p53 expression in oral squamous cell carcinoma without neck node metastases.
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.
Carlos de Vicente
Juan
J
Department of Oral and Maxillofacial Surgery, Hospital Central de Asturias, University of Oviedo, Catedrático José Serrano 33006, Oviedo, Spain. jvicente@correo.uniovi.es
Junquera Gutiérrez
Luis Manuel
LM
Zapatero
Agustín Herrero
AH
Fresno Forcelledo
Manuel Florentino
MF
Hernández-Vallejo
Gonzalo
G
López Arranz
Juan Sebastián
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000378:metabolism* / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
D016159:Tumor Suppressor Protein p53