Association of p53/p21 expression with cigarette smoking and prognosis in esophageal squamous cell carcinoma patients.
OBJECTIVE
To investigate the expression of p53 and p21 and associations with possible risk factors, such as cigarette smoking, in esophageal squamous cell carcinoma (ESCC) in northeastern Iran, a region with a high incidence of ESCC.


METHODS
The expression of p53 and p21 proteins was investigated immunohistochemically in tumor tissue from 80 ESCC patients and in 60 available paraffin-embedded blocks of adjacent normal specimens from the cases, along with normal esophageal tissue from 80 healthy subjects.


RESULTS
Positive expression of p53 protein was detected in 56.2% (45/80) of ESCC cases, and in none of the normal esophageal tissue of the control group (P < 0.001). Furthermore, 73.8% (59/80) of ESCC cases and 43.8% (35/80) of controls had positive expression of p21 protein (P < 0.001). Cigarette smoking was significantly associated with p53 over-expression in ESCC cases (P = 0.010, OR = 3.64; 95% CI: 1.32-10.02). p21 over-expression was associated with poorer clinical outcome among the ESCC patients (P = 0.009).


CONCLUSIONS
Over-expression of p53 in association with cigarette smoking may play a critical role in ESCC carcinogenesis among this high-risk population of northeastern Iran. Furthermore, p21 over-expression was found to be associated with poor prognosis, specifically in the operable ESCC patients.
Department of Medical Genetics, National Institute for Genetic Engineering and Biotechnology, Shahrak-e Pajoohesh, 17km, Tehran-Karaj High way, PO Box 14965/161, Tehran 14977-16316, Iran.
Noushin
N
Taghavi
Firouzeh
F
Biramijamal
Masoud
M
Sotoudeh
Omeed
O
Moaven
Hooman
H
Khademi
Mohammad Reza
MR
Abbaszadegan
Reza
R
Malekzadeh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000737:chemistry* / Q000453:epidemiology / Q000473:pathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D050759:Cyclin-Dependent Kinase Inhibitor p21 / Q000032:analysis*; D004938:Esophageal Neoplasms / Q000737:chemistry* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
D014408:Biomarkers, Tumor; C493956:CDKN1A protein, human; D050759:Cyclin-Dependent Kinase Inhibitor p21; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53