Prognostic impact of p53, c-erbB-2 and epidermal growth factor receptor on head and neck carcinoma.
BACKGROUND
p53, c-erbB-2 and epidermal growth factor receptor (EGFR) are cancer-related proteins that are usually expressed in head and neck squamous cell carcinoma (SCC). Their prognostic value remains controversial.


OBJECTIVE
To evaluate the prognostic impact of p53, c-erbB-2 and EGFR expression in head and neck SCC.


METHODS
Prospective.


METHODS
Head and Neck Surgery Department, Hospital AC Camargo, São Paulo.


METHODS
Fifty-four patients were studied for p53, c-erbB-2 and EGFR expression in head and neck SCC and adjacent mucosa, via immunohistochemistry. These data were correlated with histoclinical data and survival.


RESULTS
There was a direct association of p53 expression in SCC and mucosa (p = 0.001); loss of c-erbB-2 expression (-) from normal mucosa to SCC (p = 0.04); lower frequency of association of c-erbB-2 (+) with EGFR (-) in SCC (p = 0.02); and a direct association of EGFR (+) expression in SCC and mitotic index (p = 0.03). The 60-month actuarial survival rates for patients presenting lymph node metastasis were higher when there was no capsule rupture by SCC (48.3%; p = 0.02), no more than one positive lymph node (52.3%; p = 0.004) or clear surgical margins (47.0%; p = 0.01), in comparison with patients presenting capsule rupture (20.2%), two or more positive lymph nodes (18.7%) or compromised surgical margins (0.0%), respectively. Patients presenting SCC p53 (+) and EGFR (-) demonstrated greater survival (75.0%; p = 0.03) than for the remaining group (33.1%). Multivariate analysis confirmed the positive impact of p53 (+) and EGFR (-) on survival (p = 0.02).


CONCLUSIONS
Associations were found for p53, c-erbB-2 and EGFR expression with histoclinical data and prognosis. Interestingly, these results suggest that loss of mucosal c-erbB-2 expression could be involved in SCC carcinogenesis; EGFR expression in SCC is related to tumor mitotic index; and presence of p53 with absence of EGFR expression in head and neck SCC may be a prognostic factor for survival.


CONCLUSIONS
Further prospective studies should be conducted to confirm the influence of p53, c-erbB-2 and EGFR on histoclinical data and prognosis.
Parise Junior
Orlando
O
Department of Head and Neck Surgery, Hospital AC Camargo, São Paulo, Brazil. oparise@uol.com.br
Carvalho
Leda Viegas
LV
Miguel
Roberto Elias Villela
RE
Kowalski
Luiz Paulo
LP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D004812:Epidemiologic Methods; D066246:ErbB Receptors / Q000032:analysis*; D005260:Female; D006258:Head and Neck Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D008940:Mitotic Index; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D013997:Time Factors; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
D066246:ErbB Receptors; D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53