title: p63 overexpression associates with poor prognosis in head and neck squamous cell carcinoma.
abstract: p63 belongs to a protein family that includes 2 structurally related proteins, p53 and p73. The aim of this study was to investigate the biologic role of p63 in oral tumorigenesis and its possible role as prognostic marker in oral cancer. Ninety-four cases of oral squamous cell carcinoma and 10 cases of normal mucosa were analyzed for p63 expression by immunohistochemistry. Normal oral mucosa showed a basal and parabasal expression of p63. Five (5.3%) cases of oral cancer showed less than 10% of positive tumor cells; in 33 (35.1%) cases the positive tumor cells comprised between 10% and less than 30%, in 36 (38.3%) cases the positive tumor cells comprised between 30% and less than 50%, and in 20 (21.3%) cases the positive tumor cells were more than 50%. There was also a statistically significant correlation between p63 expression and tumor differentiation: p63 expression was amplified in poorly differentiated tumors (P < .05). When analyzed for prognostic significance, patients with perineural infiltration had poorer survival rates than the group with no perineural infiltration (P < .05) and patients with increased p63 expression had poorer survival rates than the group with reduced p63 expression (P < .05). The statistical analysis showed no significant correlation between p63 expression, sex, age, tumor size, staging, recurrence, and metastasis. Cases with diffuse p63 expression were more aggressive and poorly differentiated and related to a poorer prognosis. These data suggest that p63 expression may be useful to identify cases of oral squamous cell carcinoma with more aggressive and invasive phenotype providing novel diagnostic and prognostic information on individual patient survival with oral cancers.
authors.affiliation: Department of Surgical Science, University of Foggia, Foggia 71100, Italy. lomuziol@tin.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Lo Muzio
authors.forename: Andrea
authors.initials: A
authors.lastname: Santarelli
authors.forename: Rosario
authors.initials: R
authors.lastname: Caltabiano
authors.forename: Corrado
authors.initials: C
authors.lastname: Rubini
authors.forename: Tiziana
authors.initials: T
authors.lastname: Pieramici
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Trevisiol
authors.forename: Francesco
authors.initials: F
authors.lastname: Carinci
authors.forename: Rosalia
authors.initials: R
authors.lastname: Leonardi
authors.forename: Alfredo
authors.initials: A
authors.lastname: De Lillo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lanzafame
authors.forename: Pantaleo
authors.initials: P
authors.lastname: Bufo
authors.forename: Adriano
authors.initials: A
authors.lastname: Piattelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000556:secondary / Q000601:surgery; D002452:Cell Count; D002648:Child; D004268:DNA-Binding Proteins; D018572:Disease-Free Survival; D005260:Female; D016147:Genes, Tumor Suppressor; D006258:Head and Neck Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000378:metabolism / Q000473:pathology; D009062:Mouth Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D010750:Phosphoproteins / Q000378:metabolism*; D015996:Survival Rate; D015534:Trans-Activators / Q000378:metabolism*; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins
chemical_list: D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D010750:Phosphoproteins; C115051:TP63 protein, human; D015534:Trans-Activators; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins