p53 alteration independently predicts poor outcomes in patients with endometrial cancer: a clinicopathologic study of 131 cases and literature review.
OBJECTIVE
The aim of this study was to evaluate the prognostic impact of p53 alteration in human uterine endometrial adenocarcinoma.


METHODS
One hundred and thirty-one patients with primary endometrial adenocarcinoma were included in the study. The p53 mutation and/or protein expression were evaluated by polymerase chain reaction-single-strand conformational polymorphism and by immunohistochemical analysis, respectively. Clinical and pathological parameters were obtained from medical records. Survival data were estimated using Kaplan-Meier estimates and compared with the log-rank test where indicated. Multivariate analysis was performed using the Cox regression method.


RESULTS
Thirty nine cases (29.8%) containing p53 alterations had a lower disease specific-survival rate and disease-free survival rate than those without p53 alterations. Statistically significant correlations were seen between p53 alteration and non-endometrioid histology type, high grade tumors, and the absence of progesterone receptor. Multivariate analyses showed that both p53 alteration and FIGO stage at diagnosis were adverse prognostic factors. The group of women with p53 alteration had an 11.0-fold increased risk of disease specific death (95% confidence interval: 1.008-120.765) compared to women whose tumors lacked p53 alteration.


CONCLUSIONS
p53 alteration defines a subset of endometrial adenocarcinoma with highly aggressive behavior and predicts lower survival in patients with endometrial adenocarcinoma.
Lee
Eun-Ju
EJ
Department of Obstetrics and Gynecology, Chung-Ang University School of Medicine, Seoul, Korea.
Kim
Tae-Joong
TJ
Kim
Dae Shick
DS
Choi
Chel Hun
CH
Lee
Jeong-Won
JW
Lee
Je-Ho
JH
Bae
Duk-Soo
DS
Kim
Byoung-Gie
BG
D000230:Adenocarcinoma / Q000235:genetics* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D005091:Exons; D005260:Female; D016158:Genes, p53; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009154:Mutation; D016133:Polymerase Chain Reaction; D020641:Polymorphism, Single Nucleotide; D011379:Prognosis; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis / Q000235:genetics*; D055815:Young Adult
C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53