Cigarette smoking, body mass index, gastro-esophageal reflux disease, and non-steroidal anti-inflammatory drug use and risk of subtypes of esophageal and gastric cancers by P53 overexpression.
A number of risk factors for esophageal and gastric cancers have emerged, yet little is known whether risk factors map to molecular tumor markers such as overexpression of the tumor suppressor TP53. Using a US multicenter, population-based case-control study (170 cases of esophageal adenocarcinomas, 147 gastric cardia adenocarcinomas, 220 non-cardia gastric adenocarcinomas, and 112 esophageal squamous cell carcinomas), we examined whether the risk associated with cigarette smoking, body mass index (BMI), gastroesophageal reflux disease (GERD), and non-steroidal anti-inflammatory drug (NSAID) use varied by P53 overexpression. We defined P53 overexpression through immunohistochemistry of paraffin-embedded tumor tissues, using cutpoints based on percent of cells positive. Polytomous logistic regression was used to assess differences between each case group (defined by tumor subtype and P53 expression) and the control group by risk factors. The proportion of cases overexpressing P53 by tumor subtype was 72% for esophageal adenocarcinoma, 69% for gastric cardia adenocarcinoma, 52% for non-cardia gastric adenocarcinoma, and 67% for esophageal squamous cell carcinoma. For most tumor subtypes, we found little difference in risk factors by tumor P53 overexpression. For non-cardia gastric cancer however, an association with cigarette smoking was suggested for tumors that do not overexpress P53, whereas larger BMI was related to adenocarcinomas that overexpress P53 versus no overexpression. Overall, this study did not find a clear relationship between P53 protein overexpression and the known risk factors for subtypes of esophageal and gastric cancers. Further research on these tumors is needed to identify molecular markers associated with variations in the risk factor profiles.
Figueroa
Jonine D
JD
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. figueroaj@mail.nih.gov
Terry
Mary Beth
MB
Gammon
Marilie D
MD
Vaughan
Thomas L
TL
Risch
Harvey A
HA
Zhang
Fang-Fang
FF
Kleiner
David E
DE
Bennett
William P
WP
Howe
Christine L
CL
Dubrow
Robert
R
Mayne
Susan T
ST
Fraumeni
Joseph F
JF
Chow
Wong-Ho
WH
D000230:Adenocarcinoma / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D002299:Cardia; D016022:Case-Control Studies; D016001:Confidence Intervals; D004938:Esophageal Neoplasms / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D007150:Immunohistochemistry; D016015:Logistic Models; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D016017:Odds Ratio; D011159:Population Surveillance; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*; D014481:United States / Q000453:epidemiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016159:Tumor Suppressor Protein p53